title: Plakoglobin: a diagnostic marker of arrhythmogenic right ventricular cardiomyopathy in forensic pathology?
abstract: OBJECTIVE
  The histopathological diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) can be challenging in forensic medicine. Immunohistochemical myocardial analysis for plakoglobin has been suggested as a new diagnostic test for ARVC. We examined this in the setting of forensic pathology, applying this method to forensic autopsy samples.
  
  
  METHODS
  We performed immunohistochemical staining for plakoglobin on 40 myocardial samples with an autopsy diagnosis of ARVC. In addition, histopathological reevaluation was performed applying the revised 2010 task force criteria including morphometric analysis. Myocardial samples from 15 subjects without heart disease were used as controls.
  
  
  RESULTS
  Based on the histopathological reevaluation, 38 out of 40 cases were categorized as ARVC. A marked reduction in the plakoglobin staining was seen in 26 out of 38 myocardial samples in the ARVC-group. Of the two samples categorized as not ARVC, one showed reduced plakoglobin staining and one sample had normal staining. No control samples showed reduced plakoglobin staining.
  
  
  CONCLUSIONS
  In conclusion, our study displayed reduced plakoglobin staining in approximately 2/3 of myocardial samples with ARVC. Our data suggests that immunostaining for plakoglobin might serve as an additional diagnostic marker of ARVC in forensic pathology, but additional validation is required.
authors.affiliation: Section of Forensic Pathology, Department of Forensic Medicine, Faculty of Health Sciences, University of Copenhagen, Frederik V's Vej 11, 2100, Copenhagen, Denmark, munkholm@dadlnet.dk.
authors.forename: Julie
authors.initials: J
authors.lastname: Munkholm
authors.forename: Claus B
authors.initials: CB
authors.lastname: Andersen
authors.forename: Gyda L
authors.initials: GL
authors.lastname: Ottesen
mesh_terms: D000293:Adolescent; D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D001344:Autopsy; D015415:Biomarkers / Q000032:analysis; D002423:Cause of Death; D002648:Child; D051180:Desmoplakins / Q000032:analysis*; D015536:Down-Regulation; D005260:Female; D049429:Forensic Pathology / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry* / Q000473:pathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult; D051185:gamma Catenin
chemical_list: D015415:Biomarkers; D051180:Desmoplakins; C495292:JUP protein, human; D051185:gamma Catenin