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Accumulation of eosinophils, mast cells, and basophils in the spleen in anaphylactic deaths
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
2013 (English)In: Forensic Science, Medicine, and Pathology, ISSN 1547-769X, E-ISSN 1556-2891, Vol. 9, no 4, 496-500 p.Article in journal (Refereed) Published
Abstract [en]

Death in anaphylactic shock cannot be diagnosed by autopsy alone. Morphological diagnosis of anaphylactic death by counting mast cells in the lung and airways have failed to give consistent results. Previously it has been observed that eosinophils seem to accumulate in the spleen in anaphylaxis. The purpose of this study was to investigate if it is possible to safely diagnose anaphylactic deaths by counting eosinophils, mast cells, and basophils in the spleen. In 43 forensic autopsy cases specific antibodies to mast cells, eosinophil-, and basophil granulocytes were used on sections from lung and splenic tissue. The cells were counted in 20 x 40 fields in a Leica photo-microscope. Presumed deaths in anaphylaxis were compared with sudden deaths after intravenous injection of opiates, and sudden cardiac deaths (control group). The main result was that significant (p andlt; 0.05)increases of both eosinophil granulocytes (mean 26.6 +/- A 17.8/SD/)and mast cells (3.2 +/- A 2.0/SD/) versus controls (eosinophils mean 7.0 +/- A 10.5 and mast cells mean 0.9 +/- A 1.1) were seen in splenic tissue in anaphylactic deaths. Comparing cases with high and low concentrations of mast cell tryptase in serum showed a similar increase in eosinophils and mast cells in the spleen in cases with elevated tryptase, but not in the lung. The numbers of pulmonary mast cells and eosinophils were not different in anaphylactic deaths compared with controls. It is concluded that by quantifying eosinophil granulocytes and mast cells in the spleen in combination with tryptase measurements in serum it is possible to diagnose anaphylaxis with a high degree of certainty.

Place, publisher, year, edition, pages
HUMANA PRESS INC, 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA , 2013. Vol. 9, no 4, 496-500 p.
Keyword [en]
Anaphylaxis, Postmortem, Spleen, Eosinophils, Mast cells, Basophils
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:liu:diva-102071DOI: 10.1007/s12024-013-9468-9ISI: 000326348600005OAI: oai:DiVA.org:liu-102071DiVA: diva2:671175
Note

Funding Agencies|Swedish National Board of Forensic Medicine||

Available from: 2013-12-03 Created: 2013-11-29 Last updated: 2017-12-06

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Edston, Erik

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