Abstract
Nontraumatic sudden and unexpected death in the young is an uncommon event, but it is one that has tremendous impact on families and communities. Autopsy assessments may be difficult, as many entities are rare and have quite subtle manifestations. In the following chapter, a range of lethal (mostly) natural diseases that may be encountered in pediatric forensic practice are described involving central nervous system, respiratory, cardiovascular, gastrointestinal, hematopoetic, genitourinary, infectious, endocrine, metabolic, and miscellaneous conditions, the latter including connective tissue and chromosomal disorders. These are listed in Table 1.1. The issue of the “negative autopsy” is also discussed with the potential role of genetic screening. Given the broad nature of the subject matter, the chapter is not intended to be exhaustive, but covers a range of conditions that should be considered during the process of the postmortem examination process.
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Byard RW (2010) Sudden death in the young. Cambridge University Press, Cambridge
Wisten A, Messner T (2005) Symptoms preceding sudden cardiac death in the young are common but often misinterpreted. Scand Cardiovasc J 39:143–149
Frazer M, Mirchandai H (1984) Commotio cordis, revisited. Am J Forensic Med Pathol 5:249–251
Estes NAM (1995) Sudden death in young athletes. N Engl J Med 333:380–381
Marshall DT, Gilbert JD, Byard RW (2008) The spectrum of findings in cases of sudden death due to blunt cardiac trauma – “Commotio Cordis”. Am J Forensic Med Pathol 29:1–4
Phillips MF, Harper PS (1997) Cardiac disease in myotonic dystrophy. Cardiovasc Res 33:13–22
Fishbein MC, Siegel RJ, Thompson CE, Hopkins LC (1993) Sudden death of a carrier of x-linked Emery-Dreifuss muscular dystrophy. Ann Int Med 119:900–905
Finsterer J, Stöllberger C (2003) The heart in human dystrophies. Cardiology 99:1–19
Groth WJ, Groh MR, Saha C, Kincaid JC, Simmonds Z, Ciafaloni E et al (2008) Electrocardiographic abnormalities and sudden death in myotonic dystrophy type 1. N Engl J Med 358:2688–2697
Petković SM, Savić S, Simić MA (2008) Sudden death of a 17-year-old boy due to suspected Williams syndrome. Am J Forensic Med Pathol 29:83–85
Byard RW (2007) Forensic issues in Down syndrome fatalities. J Forensic Legal Med 14:475–481
Hirani R, Koszyca B, Byard RW (2008) Marfan syndrome and sudden death within a family – aetiologic, molecular and diagnostic issues at autopsy. J Forensic Legal Med 15:205–209
Schmidt G, Kallieris D (1982) Use of radiographs in the forensic autopsy. Forensic Sci Int 19:263–270
Eustace SJ, Nelson E (2004) Whole body magnetic resonance imaging. A valuable adjunct to clinical examination. Brit Med J 328:1387–1388
Griffiths PD, Paley MNJ, Whitby EH (2005) Post-mortem MRI as an adjunct to fetal or neonatal autopsy. Lancet 365:1271–1273
Jeffery A, Morgan B, Rutty GN (2007) The role of CT in forensic investigations. B Roy Col Pathol July:20–23
Thali MJ, Yen K, Schweitzer W, Vock P, Boesch C, Oxdoba C et al (2003) Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) – a feasibility study. J For Sci 48:386–403
Racette S, Sauvageau A (2007) Brain arteriovenous malformation and its implication in forensic pathology. J For Sci 52:189–191
Weller RO (1995) Subarachnoid haemorrhage and myths about saccular aneurysms. J Clin Pathol 48:1078–1081
Croft PR, Reichard RR (2009) Microscopic examination of grossly unremarkable pediatric dura mater. Am J Forensic Med Pathol 30:10–13
Nashef L, Walker F, Allen P, Sander JWAS, Shorvon SD, Fish DR (1996) Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy. J Neurol Neurosur Ps 60:297–300
Schwender LA, Troncoso JC (1986) Evaluation of sudden death in epilepsy. Am J Forensic Med Pathol 7:283–287
Lip GYH, Brodie MJ (1992) Sudden death in epilepsy: an avoidable outcome? J Roy Soc Med 85:609–611
O’Donoghue MF, Sander J (1997) The mortality associated with epilepsy, with particular reference to sudden unexpected death. Eplepsia 38(Suppl 11):S15–S19
Brown SW (1992) Sudden death and epilepsy. Seizure 1:71–73
Timmings PL (1993) Sudden unexpected death in epilepsy: a local audit. Seizure 2:287–290
Lear-Kaul KC, Coughlin L, Dobersen MJ (2005) Sudden unexpected death in epilepsy. A retrospective study. Am J Forensic Med Pathol 26:11–17
Thom M (2007) The autopsy in sudden unexpected adult death: Epilepsy. Curr Diagn Pathol 13:389–400
Schraeder PL, Lathers CM (1989) Paroxysmal autonomic dysfunction, epileptogenic activity and sudden death. Epilepsy Red 3:55–62
Oppenheimer S (1990) Cardiac dysfunction during seizures and the sudden epileptic death syndrome. J Roy Soc Med 83:134–136
Mameli O, Melis F, Giraudi D, Cualbu M, Mameli S, De Riu PL et al (1993) The brainstem cardioarrhythmogenic triggers and their possible role in sudden epileptic death. Epilepsy Red 15:171–178
Schraeder PL, Lathers CM (1983) Cardiac neural discharge and epileptogenic activity in the cat: an animal model for unexplained death. Life Sci 32:1371–1382
Rugg-Gunn FJ, Simister RJ, Squirrell M, Holdright DR, Duncan JS (2004) Cardiac arrhythmias in focal epilepsy: a prospective long-term study. Lancet 364:2212–2219
P-Codrea Tigaran S, Dalager-Pedersen S, Baandrup U, Dam M, Vesterby-Charles A (2005) Sudden unexpected death in epilepsy. Is death by seizures a cardiac disease? Am J Forensic Med Pathol 26:99–105
Malatinský J, Procházka M, Sámel M (1975) Respiratory failure as a seizure phenomenon. Brit J Anaesth 47:1019–1021
Shields LBE, Hunsaker D, Hunsaker JC, Parker JC (2002) Sudden unexpected death in epilepsy. Neuropathologic findings. Am J Forensic Med Pathol 23:307–314
Leestma JE, Kalelkar MB, Teas SS, Jay GW, Hughes JR (1984) Sudden unexpected death associated with seizures: analysis of 66 cases. Epilepsia 25:84–88
Byard RW, Bourne AJ, Hanieh A (1991) Sudden and unexpected death due to hemorrhage from occult central nervous system lesions. Pediatr Neurosurg 17:88–94
Gleckman A, Smith T (1998) Sudden unexpected death from primary posterior fossa tumours. Am J Forensic Med Pathol 19:303–308
Byard RW, Moore L (1993) Sudden and unexpected death in childhood due to a colloid cyst of the third ventricle. J Forensic Sci 38:210–213
Byard RW (1996) Mechanisms of sudden death and autopsy findings in patients with Arnold-Chiari malformation and ventriculoatrial catheters. Am J Forensic Med Pathol 17:260–263
Byard RW, Koszyca B, Qiao M (2001) Unexpected childhood death due to a rare complication of ventriculoperitoneal shunting. Am J Forensic Med Pathol 22:207–210
Byard RW, Blumbergs PC, James RA (2003) Mechanisms of unexpected death in tuberous sclerosis. J For Sci 48:172–6
Byard RW, Schliebs J, Koszyca BA (2001) Osler-Weber-Rendu syndrome – pathological manifestations and autopsy considerations. J Forensic Sci 46:698–701
Byard RW (2006) Forensic issues and possible mechanisms of sudden death in Rett syndrome. J Clin Forensic Med 13:96–99
Gilbert JD, Scott G, Byard RW (2001) Septo-optic dysplasia and unexpected adult death – an autopsy approach. J Forensic Sci 46:913–915
Wick R, Byard RW (2006) Mechanisms of unexpected and/or sudden death in Lafora disease. Forensic Sci Int 163:144–147
Wick R, Scott G, Byard RW (2007) Mechanisms of unexpected death and autopsy findings in Leigh syndrome (subacute necrotizing encephalomyelopathy). J Clin Forensic Med 14:42–45
Byard RW (2007) Forensic considerations in cases of neurofibromatosis – an overview. J Forensic Sci 52:1164–1170
Koszyca B, Moore L, Byard RW (1993) Lethal manifestations of neurofibromatosis type 1 in childhood. Pediatr Pathol 13:573–581
Bye MR, Sharma G, Konop R, Callahan C, Cataletto ME, Hilman B (2003) Laryngomalacia. emedicine topic1280:1–7
Rohde M, Banner J, Byard RW (2005) Congenital lesions associated with airway narrowing, respiratory distress and unexpected infant and early childhood death. Forensic Sci Med Pathol 1:91–96
Dada MA (1995) Laryngeal cyst and sudden death. Med Sci Law 35:72–74
Byard RW, Bourne AJ, Silver MM (1990) The association of lingual thyroglossal duct remnants with sudden death in infancy. Int J Pediatr Otolaryngol 20:107–112
Byard RW, Burrows PE, Izakawa T, Silver MM (1991) Diffuse infantile haemangiomatosis: clinicopathological features and management problems in five fatal cases. Eur J Pediatr 150:224–227
Byard RW (1996) Mechanisms of unexpected death in infants and young children following foreign body ingestion. J Forensic Sci 41:438–441
Byard RW, Jensen L (2007) Fatal asphyxial episodes in the very young – classification and diagnostic issues. Forensic Sci Med Pathol 3:177–181
Byard RW, Kennedy JD (1996) Diagnostic difficulties in cases of sudden death in infants with mandibular hypoplasia. Am J Forensic Med Pathol 17:255–9
Raven K, Reay DT, Harruff RC (1999) Artifactual injuries of the larynx produced by resuscitative intubation. Am J Forensic Med Pathol 20:31–36
Byramji A, Gilbert J, Byard R. Fatal retropharyngeal abscess – a possible marker of inflicted injury in infancy and early childhood. Forensic Sci Med Pathol 5:302–306
Byard RW, Gilbert JD. Potentially lethal complications of tracheostomy – autopsy considerations. Am J Forensic Med Pathol (in press)
Burton J, Rutty G (2003) The hospital autopsy. Oxford University Press, Oxford
Currie GP, Alluri R, Christie GL, Legge JS (2007) Pneumothorax: an update. Postgrad Med J 83:461–465
Cardel BS, Pearson RSB (1959) Death in asthmatics. Thorax 14:341–352
Champ CS, Byard RW (1994) Sudden death in asthma in childhood. Forensic Sci Int 66:117–127
Sidebotham HJ, Roche WR (2003) Asthma deaths; persistent and preventable mortality. Histopathology 43:105–117
Copeland AR (1986) Asthmatic deaths in the medical examiner’s population. Forensic Sci Int 31:7–12
Preston HV, Bowen DAL (1987) Asthma deaths: A review. Med Sci Law 27:89–94
Sur S, Crotty TB, Kephart GM, Hyma BA, Colby TV, Reed CE et al (1993) Sudden-onset fatal asthma. A distinct entity with few eosinophils and relatively more neutrophils in the airway submucosa? Am Rev Respir Dis 148:713–719
Sundararajan S, Ostojic NS, Rushton DI, Cox PM (2005) Diaphragmatic pathology: a cause of clinically unexplained death in the perinatal/paediatric age group. Med Sci Law 45:110–114
Basso C, Frescura C, Corrado D, Angelini A, Daliento L, Thiene G (1995) Congenital heart disease and sudden death in the young. Hum Pathol 26:1065–1072
Pelech AN, Neisch SR (2004) Sudden death in congenital heart disease. In: Berger S (ed) Pediatric Clinics of North America. Saunders, Philadelphia, pp 1257–1271
Råsten-Almqvist P, Rajs J (2004) Cardiovascular malformations and sudden death in infancy. Am J Forensic Med Pathol 25:134–140
Bharati S, Lev M (1986) Conduction system in cases of sudden death in congential heart disease many years after surgical correction. Chest 90:861–868
Oechslin EN, Harrion DA, Connelly MS, Webb GD, Siu SC (2000) Mode of death in adults with congenital heart disease. Am J Cardiol 86:1111–1116
Silka MJ, Hardy BG, Menashe VD, Morris CD (1998) A population-based prospective evaluation of risk of sudden cardiac death after operation for common congenital heart defects. J Am Col Cardiol 32:245–251
Byard RW, Gilbert JD (2005) Total anomalous pulmonary venous connection. Autopsy considerations. Forensic Sci Med Pathol 1:215–220
Byard RW, Moore L (1991) Total anomalous pulmonary venous drainage and sudden death in infancy. Forensic Sci Int 51:197–202
James CL, Keeling JW, Smith NM, Byard RW (1994) Total anomalous pulmonary venous drainage associated with fatal outcome in infancy and early childhood: an autopsy study of 52 cases. Pediatr Pathol 14:665–678
Frescura C, Basso C, Thiene G, Corrado D, Pennelli T, Angelini A et al (1998) Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol 29:689–695
Roberts WC (1986) Major anomalies of coronary arterial origin seen in adulthood. Am Heart J 111:941–963
Lauridson JR (1988) Sudden death and anomalous origin of the coronary arteries from the aorta. A case report and review. Am J Forensic Med Pathol 9:236–240
Taylor AJ, Rogan KM, Virmani R (1991) Sudden cardiac death associated with isolated congenital coronary artery anomalities. J Am Col Cardiol 1992:640–647
Byard RW, Jimenez CL, Carpenter BF, Cutz E, Smith CR (1991) Four unusual cases of sudden and unexpected cardiovascular death in infancy and childhood. Med Sci Law 31:157–161
Byard RW, Smith NM, Bourne AJ (1991) Association of right coronary artery hypoplasia with sudden death in an eleven-year-old child. J Forensic Sci 36:1234–1239
Lipsett J, Byard RW, Carpenter BF, Jimenez CL, Bourne AJ (1991) Anomalous coronary arteries arising from the aorta associated with sudden death in infancy and early childhood. Arch Pathol Lab Med 115:770–773
Lipsett J, Cohle SD, Berry PJ, Russell G, Byard RW (1994) Anomalous coronary arteries: a multicentre pediatric autopsy study. Pediatr Pathol 14:287–300
Moore L, Byard RW (1992) Sudden and unexpected death in infancy associated with a single coronary artery. Pediatr Pathol 12:231–236
Byard RW (1996) Vascular causes of sudden death in infancy, childhood, and adolescence. Views and Reviews in Vascular Medicine and Biology. Cardiovasc Pathol 5:243–257
Stahl J, Santos LD, Byard RW (1995) Coronary artery thromboembolism and unexpected death in childhood and adolescence. J Forensic Sci 40:599–601
Kato H, Ichinose E, Yoshioka F, Takechi T, Matsunaga S, Rikitake N (1982) Fate of coronary artery aneurysm in kawasaki disease: serial coronary angiography and long-term follow-up study. Am J Cardiol 49:1758–1766
Rozin L, Koehler S, Shakir A, Ladham S, Wecht CH (2003) Kawasaki disease. A review of pathologic features of stage IV disease and two cases of sudden death among asymptomatic young adults. Am J Forensic Med Pathol 24:45–50
Zuccollo JM, Byard RW (2001) Test and Teach. (Sudden infant death due to Kawasaki disease). Pathology 33:235–238
Ropponen KM, Alafuzoff I (1999) A case of sudden death caused by fibromuscular dysplasia. J Clin Pathol 52:541–542
Byard RW (1996) Idiopathic arterial calcification and unexpected infant death. Pediatr Pathol Lab Med 16:895–994
Byard RW, Cutz E (1990) Sudden and unexpected death in infancy and childhood due to pulmonary thromboembolism. Arch Pathol Lab Med 114:142–144
Champ C, Byard RW (1994) Pulmonary embolism and unexpected death in infancy. J Paediatr Child Health 30:550–551
Moore L, Byard RW (1992) Fatal paradoxical embolism to the left carotid artery during partial resection of Wilms’ tumor. Pediatr Pathol 12:551–556
Byard RW, Bourne AJ (1991) Cardiac echinococcosis with fatal intracerebral embolism. Arch Dis Child 66:155–156
Fothergill DF, Bowen DAL, Mason JK (1979) Dissecting and atherosclerotic aneurysms: a survey of post-mortem examinations, 1968–77. Med Sci Law 19:253–260
Byard RW (1994) Ventricular septal defect and sudden death in early childhood. J Paediatr Child Health 30:439–440
Byard RW, Bourne AJ, Adams PS (1990) Subarterial ventricular septal defect in an infant with sudden unexpected death: cause or coincidence? Am J Cardiovasc Pathol 3:333–336
Cohle SD, Graham MA, Dowling G, Pounder DJ (1988) Sudden death and left ventricular outflow disease. Pathol Annu 2:97–124
Hennersdorf MG, Strauer BE (2001) Arterial hypertension and cardiac arrhythmias. J Hypertens 19:167–177
Davies MJ, McKenna WJ (1995) Hypertrophic cardiomyopathy – pathology and pathogenesis. Histopathology 26:493–500
Hughes SE (2004) The pathology of hypertrophic cardiomyopathy. Histopathology 44:412–427
Marron BJ, Bonow RO, Cannon RO, Leon MB, Epstein SE (1987) Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy. (First of two parts). N Engl J Med 316:780–789
Dec GW, Fuster V (1995) Idiopathic dilated cardiomyopathy. N Engl J Med 331:1564–1575
Roberts WC, Siegel RJ, McManus BM (1987) Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients. Am J Cardiol 60:1340–1355
Steinherz L, Steinherz P (1991) Delayed cardiac toxicity from anthracycline therapy. Pediatrician 18:49–52
Tsuda N, Oka R, Kajino H, Kajino M, Okuno A (2000) Sudden death of a patient in complete remission after anthracycline therapy for acute lymphoblastic leukaemia. Pediatr Int 42:319–321
Stahl J, Couper RTL, Byard RW (1997) Oncocytic cardiomyopathy: a rare cause of unexpected early childhood death associated with fitting. Med Sci Law 37:84–87
Chin TK, Perloff JK, Williams RG, Jue K, Mohrmann R (1990) Isolated noncompaction of left ventricular myocardium. A study of eight cases. Circulation 82:507–513
Ichida F, Hamamichi Y, Miyawaki T, Ono Y, Kamiya T, Akagi T et al (1999) Clinical features of isolated noncompaction of the ventricular myocardium. J Am Col Cardiol 34:233–240
Murphy RT, Thaman R, Blanes JG, Ward D, Sevedalis E, Papra E et al (2005) Natural history and familial characteristics of isolated left ventricular non-compaction. Eur Heart J 26:187–192
Varnava AM (2001) Isolated left ventricular non-compaction: a distinct cardiomyopathy? Heart 86:599–600
Weiford BC, Subbarao VD, Mulhern KM (2004) Noncompaction of the ventricular myocardium. Circulation 109:2965–2971
Burke AP, Afzal MN, Barnett DS, Virmani R (1999) Sudden death after a cold drink. Am J Forensic Med Pathol 20:37–39
Gay JD, Guileyardo JM, Townsend-Parchman JK, Ross K (1996) Clinical and morphological features of lipomatous hypertrophy (“massive fatty deposits”) of the interatrial septum. Am J Forensic Med Pathol 17:43–8
Anders S, Said S, Schulz F, Püschel K (2007) Mitral valve prolapse syndrome as a cause of sudden death in young adults. Forensic Sci Int 171:127–130
Hayek E, Gring CN, Griffin BP (2005) Mitral valve prolapse. Lancet 365:507–518
Pocock W, Bosman CK, Chesler E, Barlow JB, Edwards JE (1984) Sudden death in primary mitral valve prolapse. Am Heart J 107:378–382
Scheurman EH (1989) Myxoid heart disease: a review with special emphasis on sudden cardiac death. Forensic Sci Int 40:203–210
Kligfield P, Levy D, Devereux RB, Savage DD (1987) Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 113:1298–1307
Cohle SD, Graham MA, Sperry K, Dowling G (1989) Unexpected death as a result of infective endocarditis. J For Sci 34:1374–86
Josselson A, Bagnall JW, Virmani R (1984) Acute rheumatic carditis causing sudden death. Am J Forensic Med Pathol 5:151–154
Vevaina SC, Dastur DK, Manghani DK, Shah NA (1985) Changes in atrial biopsies in chronic rheumatic heart disease II: muscle fibre reaction. Path Res Pract 179:600–609
Skinner JR, Duflou JA, Semsarian C (2008) Reducing sudden death in young people in Australia and New Zealand: the TRAGADY initiative. Med J Australia 10:539–540
Gallagher PJ (1994) The investigation of cardiac death. In: Anthony PP, MacSween RNM (eds) Recent advances in histopathology. Longman, Edinburgh, pp 123–146
McRae TA, Chung MK, Asher CR (2001) Arrhythmogenic right ventricular cardiomyopathy: a cause of sudden death in young people. Clev Clin J Med 68:459–467
Burke AP, Farb A, Tashko G, Virmani R (1998) Arrhythmogenic right ventricular cardiomyopathy and fatty replacement of the right ventricular myocardium. Are they different diseases? Circulation 97:1571–1580
Calabrese F, Basso C, Carturan E, Valente M, Thiene G (2006) Arrhythmogenic right ventricular cardiomyopathy/dysplasia: is there a role for viruses? Cardiovasc Pathol 15:11–17
Corrado D, Basso C, Thiene G (2000) Arrhythmogenic right ventricular cardiomyopathy: diagnosis, prognosis and treatment. Heart 83:588–595
D’Amati G, Leone O, Di Gioia CRT, Magelli C, Arpesella G, Grillo P et al (2001) Arrhythmogenic right ventricular cardiomyopathy: clinicopathologic correlation based on a revised definition of pathologic patterns. Hum Pathol 32:1078–1086
Sheppard MN (1998) Arrhythmogenic right ventricular dysplasia and arrhythmogenic right ventricular cardiomyopathy: do these entities exist and are they the same disease? Curr Diagn Pathol 5:150–156
Tabib A, Liore R, Chalabreysse L, Meyronnet D, Miras A, Malicier D et al (2003) Circumstances of death and gross and microscopic observations in a series of 200 cases of sudden death associated with arrhythmogenic right ventricular cardiomyopathy and/or dysplasia. Circulation 108:3000–3005
Fornes P, Ratel S, Lecomte D (1998) Pathology of arrhythmogenic right ventricular cardiomyopathy/dysplasia – an autopsy study of 20 forensic cases. J For Sci 43:777–783
Gemayel C, Pelliccia A, Thompson PD (2001) Arrhythmogenic right ventricular cardiomyopathy. J Am Col Cardiol 38:1773–1781
Michalodimitrakis M, Papadomanolakis A, Stiakakis J, Kanaki K (2002) Left side right ventricular dysplasia. Med Sci Law 42:313–317
Shrapnel M, Gilbert JD, Byard RW (2001) “Arrhythmogenic left ventricular dysplasia” and sudden death. Med Sci Law 41:159–162
Davies MJ (1981) Pathological view of sudden cardiac death. Brit Heart J 45:88–96
Aretz HT (1987) Myocarditis: The Dallas criteria. Hum Pathol 18:619–624
Smith NM, Bourne AJ, Clapton WC, Byard RW (1992) The spectrum of presentation at autopsy of myocarditis in infancy and childhood. Pathology 24:129–131
Corby C (1960) Isolated myocarditis as a cause of sudden death. Med Sci Law 1:23–31
Cohle SD, Sampson BA (2001) The negative autopsy: sudden cardiac death or other? Cardiovasc Pathol 10:219–222
Dettmeyer R, Kandolf R, Schmidt P, Schlamann M, Madea B (2001) Lympho-monocytic enteroviral myocarditis: traditional, immunohistological and molecular pathological methods for diagnosis in a case of suspected sudden infant death syndrome (SIDS). Forensic Sci Int 119:141–144
Baughman KL (2006) Diagnosis of myocarditis. Death of Dallas criteria. Circulation 113:593–595
Byard RW (2000) Sudden infant death, large intestinal volvulus and a duplication cyst of the terminal ileum. Am J Forensic Med Pathol 21:62–64
Byard RW, Simpson A (2001) Sudden death and intussusception in infancy and childhood - autopsy considerations. Med Sci Law 41:41–45
Levin TL, Liebling MS, Ruzal-Shapiro C, Berdon WE, Stolar CJ (1995) Midgut malfixation in patients with congenital diaphragmatic hernia: what is the risk of midgut volvulus? Pediatr Radiol 25:259–261
Byard RW, Wick R (2008) Congenital mesenteric anomalies and unexpected death. Ped Develop Pathol 15:205–209
Byard RW, Couper RTL, Cohle S (2001) Gastric distension, cerebral palsy and unexpected death. J Clin Forensic Med 8:81–85
Cox DE (1997) Intussusception: agonal phenomenon or cause of death? Med Sci Law 37:355–358
Byard RW, Donald TG, Rutty G (2008) Non-traumatic causes of perianal hemorrhage and excoriation in the young. Forensic Sci Med Pathol 4:159–163
Byard RW, Bohn DJ, Wilson G, Smith CR, Ein SH (1990) Unsuspected diaphragmatic hernia: a potential cause of sudden and unexpected death in infancy and early childhood. J Pediatr Surg 25:1166–1168
Byard RW, Bourne AJ, Cockington RA (1991) Fatal gastric perforation in a 4-year-old child with a late-presenting congenital diaphragmatic hernia. Pediatr Surg Int 6:44–46
Vandy FC, Landrum JE, Gerig NR, Prahlow JA (2008) Death due to late-presenting congenital diaphragmatic hernia in a 2-year-old child. Am J Forensic Med Pathol 29:75–79
Whybourne A, Zillman MA, Miliauskas J, Byard RW (2001) Sudden and unexpected infant death due to occult lymphoblastic leukaemia. J Clin Forensic Med 8:160
Graham JK, Mosunjac M, Hanzlick RL, Mosunjac M (2007) Sickle cell lung disease and sudden death. A retrospective/prospective study of 21 autospy cases and literature review. Am J Forensic Med Pathol 28:168–172
Wirthwein DP, Spotswood SD, Barnard SD, Barnard JJ, Prahlow JA (2001) Death due to microvascular occlusion in sickle-cell trait following physical exertion. J For Sci 46:399–401
Thogmartin JR, Wilson CI, Palma NA, Ignacio SS, Pellan WA (2009) Histological diagnosis of sickle cell trait. A blinded analysis. Am J Forensic Med Pathol 30:36–39
Manton N, Smith NM, Byard RW (2000) Unexpected childhood deaths due to hemolytic uremic syndrome. Am J Forensic Med Pathol 21:90–92
Bonin S, Petrera F, Niccolini B, Stanta G (2003) PCR analysis in archival postmortem tissues. J Clin Pathol Mol Pathol 56:184–186
Landi KK, Coleman AT (2008) Sudden death in toddlers caused by influenza B infection: a report of two cases and a review of the literature. J For Sci 53:213–215
Byard RW (2002) Unexpected death due to infectious mononucleosis. J Forensic Sci 47:202–204
Byard RW, Silver MM (1993) Sudden infant death and acute posterior lingual inflammation. Int J Pediatr Otorhinolaryngol 28:77–81
Byard RW (2008) Tonsillitis and sudden childhood death. J Forensic Legal Med 15:516–518
Byramji A, Gilbert JD, Byard R. Sudden death as a complication of bacterial endocarditis. Am J Forensic Med Pathol 32:140–142
Gilbert JD, Warner M, Byard RW (2009) Lemierre syndrome and unexpected death in childhood. Am J Forensic Med Pathol 16:478–481
Zack F, Kilngel K, Kandolf R, Wegener R (2995) Sudden cardiac death in a 5-year-old girl associated with parvovirus B19 infection. Forensic Sci Int 155:13–17
Byard RW (2009) An analysis of possible mechanisms of unexpected death occurring in hydatid disease (echinococcosis). J For Sci 54:919–922
Little D, Wilkins B (1997) Haemorrhagic shock and encephalopathy syndrome. An unusual cause of sudden death in children. Am J Forensic Med Pathol 18:79–83
Burke MP, Opeskin K (1999) Adrenocortical insufficiency. Am J Forensic Med Pathol 20:60–65
Tough SC, Green FH, Paul JE, Wigle DT, Butt JC (1996) Sudden death from asthma in 108 children and young adults. J Asthma 33:179–188
Clapper A, Nashelsky MB, Dailey M (2008) Evaluation of serum cortisol in the postmortem diagnosis of acute adrenal insufficiency. Am J Forensic Med Pathol 29:181–184
Balasooriya BAW, St Hill CA, Williams AR (1984) The biochemistry of vitreous humour. A comparative study of the potassium, sodium and urate concentrations in the eyes at identical time intervals after death. Forensic Sci Int 26:85–91
Coe JI (1972) Use of chemical determinants on vitreous humor in forensic pathology. J For Sci 17:541–546
Coe I (1993) Postmortem Chemistry Update. Am J Forensic Med Pathol 14:91–117
Irwin J, Cohle SD (1988) Sudden death due to diabetic ketoacidosis. Am J Forensic Med Pathol 9:119–121
Tattersall RB, Gill GV (1990) Unexplained deaths of type I diabetic patients. Diabetic Med 8:49–58
Wei OY, Teece S (2006) Urine dipsticks in screening for diabetes mellitus. Emerg Med J 23:138
Osuna E, Vivero G, Conejero J, Abenza JM, Martínez P, Luna A et al (2005) Postmortem vitreous humor β-hydroxybutyrate: its utility for the postmortem interpretation of diabetes mellitus. Forensic Sci Int 153:189–195
Goullé J-P, Lacroix C, Bouige D (2002) Glycated hemoglobin: a useful post-mortem reference marker in determining diabetes. Forensic Sci Int 128:44–49
Khuu HM, Robinson AC, Brissie RM, Konrad RJ (1999) Postmortem diagnosis of unsuspected diabetes mellitus established by determination of decedent’s hemoglobin A1c level. J For Sci 44:643–646
Winecker RE, Hammett-Stabler C, Chapman JF, Ropero-Miller JD (2002) HbA1c as a postmortem tool to identify glycemic control. J For Sci 47:1373–1379
Batalis NI, Prahlow JA (2004) Accidental insulin overdose. J For Sci 49:1117–1120
Haibach H, Shah JH (1987) Homicide by insulin administration. J For Sci 32:208–216
Kock KF, Vestergaard V (1994) Armanni-Ebstein lesions of the kidney: diagnostic of death in diabetic coma? Forensic Sci Int 67:169–174
Gama R, Teale JD, Marks V (2003) Best Practice No 173. Clinical and laboratory investigation of adult spontaneous hypoglycaemia. J Clin Pathol 56:641–646
Patel F (1994) Diabetic death bed: post-mortem determination of hypoglycemia. Med Sci Law 34:84–87
Kernbach-Wighton G, Sprung R, Püschel K (2001) On the diagnosis of hypoglycemia in car drivers - including a review of the literature. Forensic Sci Int 115:89–94
Gilbert-Barness E, Barness L (2000) Metabolic diseases: foundations of clinical management, genetics and pathology. Eaton press. Natick, Mass
Young TW (1992) Reye’s syndrome. A diagnosis occasionally made first at medicolegal autopsy. Am J Forensic Med Pathol 13:21–27
Byard RW (2006) Sudden death in Marfan syndrome. In: Tsokos M (ed) Forensic pathology reviews. Humana Press, pp 93–106
Byard RW, Keeley FW, Smith CR (1990) Type IV Ehlers-Danlos syndrome presenting as sudden infant death. Am J Clin Pathol 93:579–582
Riches KJ, Byard RW (2004) The detection of fatal anaphylaxis at autopsy – an overview. Scand J Forensic Sci 10:61–63
Langlois NEI (2006) The use of histology in 638 coronial post-mortem examinations of adults: an audit. Med Sci Law 46:310–320
Langlois NEI (2009) Sudden adult death: a review. Forensic Sci Med Pathol 5:210–232
Lawler W (1990) The negative coroner’s necropsy: a personal approach and consideration of difficulties. J Clin Pathol 43:977–980
Thomas AC, Knapman PA, Krikler DM, Davies MJ (1988) Community study of the causes of “natural” sudden death. Br Med J 297:1453–1456
Meek S, Morris F (2002) ABC of clinical electrocardiography. Introduction. II-Basic terminology. Br Med J 324:470–473
Morita H, Wu J, Zipes DP (2008) The QT syndromes: long and short. Lancet 372:750–763
Gupta A, Lawrence A, Krishnan K, Kavinsky CJ, Trohman RG (2007) Current concepts in the mechanisms and management of drug-induced QT prolongation and torsade de pointes. Am Heart J 153:891–899
Algra A, Tijssen JGP, Roelandt JRTC, Pool J, Lubsen J (1991) QTc prolongation measured by standard 12-lead electrocardiology is an independent risk factor for sudden death due to cardiac arrest. Circulation 83:1888–1894
Towbin JA (2004) Molecular genetic basis of sudden cardiac death. In: Berger S (ed) Pediatric clinics of North America. Saunders, Philadelphia, pp 1229–1253
Priori S, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M et al (2003) Risk stratification in the long-QT syndrome. N Engl J Med 348:1866–1874
Roden DM (2008) Long-QT syndrome. N Engl J Med 358:169–176
Brugada P, Brugada J (1992) Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicentre report. J Am Col Cardiol 20:1391–1396
Doolan A, Langlois NEI, Chiu C, Ingles J, Lind J, Semsarian C (2008) Postmortem molecular analysis of KCNQ1 and SCN5A genes in sudden unexplained death in young Australians. Int J Cardiol 23:138–141
Oliva A, Pascali VL, Hong K, Brugada R (2005) Molecular autopsy of sudden cardiac death (SCD). The challenge of forensic pathologist to the complexity of genomics. Am J Forensic Med Pathol 26:369–370
Priori SG, Napolitano C (2006) Molecular underpinning of “Good Luck”. Circulation 114:360–362
Di Paolo M, Luchini D, Bloise R, Priori SG (2004) Postmortem molecular analysis in victims of sudden unexplained death. Am J Forensic Med Pathol 25:182–184
Johnson JN, Hofman N, Haglund CM, Cascino GD, Wilde AAM, Ackerman MJ (2009) Identification of a possible pathogenic link between congenital long QT syndrome and epilepsy. Neurology 72:224–231
Rosero SZ, Zareba W, Moss AJ, Robinson JL, Ali RH, Locati EH et al (1999) Asthma and the risk of cardiac events in the long QT syndrome. Am J Cardiol 84:1406–1411
Start RD, Barber C, Kaschula ROC, Robinson RTCE (2007) The “dead in bed syndrome” – cause of sudden death in Type 1 diabetes mellitus. Histopathology 51:843–845
Tu E, Twigg SM, Duflou J, Semsarian C (2008) Causes of death in young Australians with type 1 diabetes: a review of coronial postmortems. Med J Aust 188:699–702
Veglio M, Chinaglia A, Cavallo-Perin P (2004) QT interval, cardiovascular risk factors and risk of sudden death in diabetes. J Endocrinol Invest 27:175–181
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Langlois, N.E.I., Byard, R.W. (2011). Sudden Natural Deaths in Infancy and Childhood. In: Turk, E. (eds) Forensic Pathology Reviews. Forensic Pathology Reviews, vol 6. Humana Press. https://doi.org/10.1007/978-1-61779-249-6_1
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