Document Detail

Intrathoracic petechial hemorrhages in sudden infant death syndrome and other infant deaths: time for re-examination.
MedLine Citation:
PMID:  18416633     Owner:  NLM     Status:  MEDLINE    
The objective of this study was to provide a predictive tool to assist forensic and pediatric pathologists in the diagnosis of sudden unexpected infant death and to discuss the pathogenesis of intrathoracic petechial hemorrhages through a retrospective autopsy report review of 174 sudden infant death syndrome (SIDS) cases (2004 definition) and 67 age-matched comparison deaths. The setting was a qualitative assessment (presence or absence) of macroscopic intrathoracic petechiae in SIDS and age-matched comparison of sudden unexpected deaths that occurred in the late 1980s and early 1990s. Sensitivity, specificity, and positive and negative predictive values for thymic, pleural, and epicardial petechial hemorrhages were developed. Results showed 89.5%, 80%, and 79.9% SIDS (<12 months of age) had thymic, pleural, and epicardial petechiae, respectively, compared with 47.6%, 47.5% and 43.6% in non-SIDS deaths, respectively. Respective odds ratios were: 9.4 (4.5 to 19.9), 4.6 (2.3 to 9.1), 5.3 (2.6 to 10.8). When all 3 intrathoracic organ sites contain macroscopic petechiae, this is 84.9% predictive of SIDS; when all 3 sites have no detectable petechiae this is 93.1% predictive of a non-SIDS diagnosis. Thus, we conclude that careful assessment of intrathoracic petechiae at autopsy is likely to be diagnostically useful in the assessment of sudden unexplained infant death.
Paul N Goldwater
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  11     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    2008 Nov-Dec
Date Detail:
Created Date:  2009-01-15     Completed Date:  2009-03-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  450-5     Citation Subset:  IM    
Microbiology & Infectious Diseases Department, the Women's & Children's Hospital, Discipline of Paediatrics, Children, Youth & Women's Health Service, North Adelaide, South Australia 5006, Australia.
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MeSH Terms
Cause of Death*
Diagnosis, Differential
Hemothorax / diagnosis*,  epidemiology
Infant, Newborn
Odds Ratio
Predictive Value of Tests
Purpura / diagnosis*,  epidemiology
Retrospective Studies
South Australia / epidemiology
Sudden Infant Death / diagnosis*,  epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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