Myocarditis misdiagnosed as sudden infant death syndrome (SIDS).
In a retrospective study spanning five years, the histologic sections of 35 autopsies of infants diagnosed as SIDS victims were reviewed. Based on a recently reported study in which findings on marked basement membrane thickening (BMT) in the true vocal cords was suggested as a pathognomonic marker of SIDS, we expected to find BMT in all these cases. However, in seven of the reviewed autopsies (20%) no BMT was detected. Examination of new histologic sections of all the victims revealed myocarditis in these seven cases. In a control group (n = 18) of children with known cause of death, neither BMT nor myocarditis were found. The incidence of myocardial diseases in infants and young adults (20% and 22% respectively) reported in the literature indicates that myocarditis is not a rare cause of sudden death in infants. Therefore, in SIDS-suspected cases a meticulous post-mortem microscopic examination of the heart should be carried out, especially whenever BMT of the vocal cords is absent.
Shatz
A
A
Sackler Faculty of Medicine, Tel Aviv University, Israel.
Hiss
J
J
Arensburg
B
B
D001485:Basement Membrane / Q000473:pathology; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000175:diagnosis*; D009206:Myocardium / Q000473:pathology; D012189:Retrospective Studies; D013398:Sudden Infant Death / Q000175:diagnosis*; D014827:Vocal Cords / Q000473:pathology