title: PATHOLOGY IMAGE OF THE MONTH. Autopsy Findings in an Adult with Down Syndrome.
abstract: Emergency medical responders were activated to the home of a 59-year-old African-American male in distress and with known Down syndrome complicated by Alzheimer’s disease. He was found to be unresponsive and subsequently became pulseless. Advanced cardiac life support protocols were initiated and continued for two hours in the emergency department. Due to family request, efforts were eventually ceased and the patient was declared dead. Full, unrestricted autopsy examination was conducted under the coroner’s authorization. The cause of death was determined to be a pulmonary thromboembolus in the main pulmonary artery with extension into the bilateral pulmonary arteries. Additional external findings included alopecia universalis, penoscrotal hypospadias, ostium secundum type of atrial septal defect, right ventricular cardiac dilatation, diffuse cerebral atrophy, facial features compatible with Down syndrome, and generalized patches of skin depigmentation over the hands as seen in Figure 1 but also over the feet, lips, areola, and trunk. Microscopic findings included features of pulmonary hypertension. A microscopic image from a section of the thyroid is seen in Figure 2.
authors.affiliation: Second-year Pathology Resident in the Department of Pathology at Louisiana State University's School of Medicine in New Orleans.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Connor
authors.affiliation: Third-year Pathology Resident in the Department of Pathology at Louisiana State University's School of Medicine in New Orleans.
authors.forename: Ally
authors.initials: A
authors.lastname: Darga
authors.affiliation: Associate Professor of Pathology and Residency Program Director at Louisiana State University's School of Medicine in New Orleans.
authors.forename: Robin R
authors.initials: RR
authors.lastname: McGoey
mesh_terms: D000544:Alzheimer Disease / Q000473:pathology*; D015897:Comorbidity; D004314:Down Syndrome / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000473:pathology; D013961:Thyroid Gland / Q000473:pathology*