Pérez-Platz U, Saeger W, Dhom G, Bajanowski T
Department of Pathology of the Marienkrankenhaus, Hamburg, Germany.
Int J Legal Med. 1994;106(5):244-8. doi: 10.1007/BF01225413.
The sudden infant death syndrome (SIDS) is at present based on unknown pathogenetical mechanisms but in industrial nations is the most common cause of death in infancy after the perinatal period. Studies of a large number of adrenal glands in this syndrome have not been reported. Therefore, we evaluated 146 SIDS cases (85 males, 61 females, aged 14-465 days) and 24 control cases (17 males, 7 females, aged 18-623 days) by light microscopy, morphometry and immunocytochemistry (anti-chromogranin A and anti-S100 protein). Our data revealed a normal maturation of the adrenal glands in SIDS cases. Necroses, extensive hemorrhages or inflammation were not found. A focal lipid depletion of the zona fasciculata was seen in 92% of the adrenal glands of the SIDS and control cases. We found a siderosis (in 33% of the SIDS cases and 4% of the control cases) and calcium deposits (13% and 12% respectively) due to hyperemic involution of the fetal zone. The medulla, including the sustentacular cells (S 100 protein-positive cells) and chromaffin cells (chromogranin A-positive cells) was unchanged. Our results indicate that the few morphological alterations of the adrenal glands in SIDS cases are the effect of the underlying disease and not the cause of the sudden death.
婴儿猝死综合征（SIDS）目前病因不明，但在工业化国家，它是围产期后婴儿期最常见的死亡原因。尚未有关于大量该综合征肾上腺的研究报告。因此，我们通过光学显微镜、形态计量学和免疫细胞化学（抗嗜铬粒蛋白A和抗S100蛋白）对146例SIDS病例（男85例，女61例，年龄14 - 465天）和24例对照病例（男17例，女7例，年龄18 - 623天）进行了评估。我们的数据显示，SIDS病例的肾上腺成熟正常。未发现坏死、广泛出血或炎症。在SIDS病例和对照病例的92%肾上腺中可见束状带局灶性脂质消耗。我们发现由于胎儿带充血性退化导致的铁质沉着（SIDS病例中33%，对照病例中4%）和钙沉积（分别为13%和12%）。髓质，包括支持细胞（S100蛋白阳性细胞）和嗜铬细胞（嗜铬粒蛋白A阳性细胞）未发生变化。我们的结果表明，SIDS病例中肾上腺的少数形态学改变是潜在疾病的结果，而非猝死的原因。
