Unexpected death of a patient with rheumatoid arthritis complicated by a cervical deformity.
An elderly female with a 43-year history of rheumatoid arthritis died 2weeks after the onset of chest discomfort, electrolyte disturbance, and interstitial pneumonia. She had frequent premature ventricular contractions, fluctuating heart rate, and hypotension. Ischemic heart disease and interstitial pneumonia were excluded as the cause of death based on clinical course and autopsy findings. A severe cervical deformity with myelopathy likely contributed to circulatory instability, possibly through injury to the intra-spinal sympathetic nervous system, which can induce cardiovascular instability and suppress respiratory function. This likely led to death.
Unuma
Kana
K
Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan.
Harada
Kazuki
K
Nakajima
Makoto
M
Ito
Takako
T
Okutsu
Kosuke
K
Yoshida
Ken-ichi
K
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D001344:Autopsy; D003645:Death, Sudden; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D013117:Spinal Cord Compression / Q000150:complications*