title: Sudden unexpected death due to Graves' disease during physical altercation.
abstract: We report a case of a 30-year-old woman who suddenly collapsed after having a physical altercation with her husband. Despite immediate resuscitation, she died on arrival at the hospital. The victim's parents requested an autopsy because they believed that their daughter was killed by her husband. Postmortem examination revealed that the victim had a diffusely enlarged thyroid gland and cardiomegaly with left ventricular hypertrophy. There was no evidence of significant trauma on the body. Further postmortem thyroid function tests and review of her medical history indicated that her death was due to Graves' disease. To the best of our knowledge, this is the first case reported of sudden death due to cardiac arrhythmia from Graves' disease induced by physical and emotional stress associated with the criminal activity of another person. The autopsy findings are described. In addition, the literature is reviewed and the significance of postmortem evaluation of thyroid hormones in the cases of sudden death is discussed.
authors.affiliation: University of Ningbo School of Medicine, Ningbo City, Zhejiang, 315211, China.|University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
authors.forename: Dengming
authors.initials: D
authors.lastname: Wei
authors.affiliation: Ningbo Municipal Public Security Bureau of Criminal Science and Technology Research Institute, Ningbo city, Zhejiang, 315103, China.
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Yuan
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.|Key Laboratory of Evidence Science, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Tiantong
authors.initials: T
authors.lastname: Yang
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.|Key Laboratory of Evidence Science, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chang
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
authors.forename: Allen
authors.initials: A
authors.lastname: Burke
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.|Key Laboratory of Evidence Science, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, 21201, USA.|Key Laboratory of Evidence Science, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000209:etiology*; D006332:Cardiomegaly / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology*; D017579:Domestic Violence; D005260:Female; D049429:Forensic Pathology; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000473:pathology; D055118:Medication Adherence; D009929:Organ Size; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000150:complications; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000473:pathology
keywords: Graves' disease; cardiomegaly; forensic autopsy; forensic science; hyperthyroidism; sudden unexpected death
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