Factors involved in the pathogenesis of unexpected near miss events of infants (ALTE).
Near miss events or apparent life threatening events (ALTE) are considered preliminary stages of sudden infant death syndrome (SIDS). The current definition of near miss SIDS postulates that such an event happens unexpectedly and that no life threatening cause of disease can be detected. However in 32 of 34 observations of ALTE pathological changes actually could be identified by through investigations: 11 central nervous diseases, 10 respiratory tract disturbances, 5 metabolic abnormalities, 5 disturbances of the digestive tract and 1 cardiac disease. There were 22 morphologically manifested causes as opposed to 10 functional failures mainly respiratory control and oesophageal disturbances. Irrespective of the main diagnosis sleep apnea syndrome (SAS) could be detected in 17 of 28 infants combined with bradycardia in 5 cases, and oesophageal disturbances in 16 of 17 infants. Four babies later died, two of them suffered from carnitine deficiency and one from organic acidopathy. It is our conclusion that numerous, even banal causes of disease are able to trigger ALTE if there is a coincidence with phases of increased instability of vital regulatory mechanisms of autonomous centres in infants.
Kurz
R
R
Department of Pediatrics, University of Graz, Austraia.
Kenner
T
T
Reiterer
F
F
Schenkeli
R
R
Haidmayer
R
R
Stöckler
S
S
Paschke
E
E
D001927:Brain Diseases / Q000150:complications; D004935:Esophageal Diseases / Q000150:complications; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D012140:Respiratory Tract Diseases / Q000150:complications; D012307:Risk Factors; D013398:Sudden Infant Death / Q000209:etiology* / Q000517:prevention & control