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Postmortale Diagnostik einer (post-)viralen Myokarditis bei mutmaßlichem plötzlichem Säuglingstod

Fallbericht zur Fehlervermeidung bei der Diagnostik

Postmortem diagnostics of a (post-)viral myocarditis in putative sudden infant death syndrome

Case report for avoidance of errors in the diagnostics

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Zusammenfassung

Die Diagnose einer Myokarditis im Säuglingsmyokard setzt mikroskopische Erfahrung und häufig eine Mindestzahl an Gewebeproben bzw. Gewebeschnitten voraus. Je nach Chronologie der Myokarditis können immunhistochemische Methoden den Myokarditisverdacht erhärten oder sogar begründen, wenn die Färbungen technisch korrekt gelungen sind. Die sog. Dallas-Kriterien für eine Myokarditis müssen nicht zwingend vorliegen, ermöglichen jedoch auch weniger erfahrenen Untersuchern zwanglos die Diagnose. Fokale entzündliche Infiltrate bei fehlendem Nachweis eines viralen Genoms sprechen für eine postvirale (Autoimmun-)Myokarditis.

Abstract

The diagnosis of myocarditis in infants requires microscopic experience and often a minimum number of tissue samples and sections taken from the myocardium. Depending on the chronology of a myocarditis, immunohistochemical methods can be helpful to support the suspicion of myocarditis or even confirm it, if staining procedures have been correctly carried out. The so-called Dallas criteria are not mandatory to diagnose myocarditis; however, they make the diagnosis possible even for less experienced investigators. Focal inflammatory infiltration without detection of the viral genome is indicative of post-viral (autoimmune) myocarditis.

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  1. Institut für Rechtsmedizin, Justus-Liebig-Universität, Universitätsklinikum Gießen & Marburg GmbH, Frankfurter Str. 58, 35392, Gießen, Deutschland

    R. Dettmeyer

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Dettmeyer, R. Postmortale Diagnostik einer (post-)viralen Myokarditis bei mutmaßlichem plötzlichem Säuglingstod. Rechtsmedizin 26, 514–519 (2016). https://doi.org/10.1007/s00194-016-0111-4

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  • DOI: https://doi.org/10.1007/s00194-016-0111-4

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