title: Sudden Infant Death With Area Postrema Lesion Likely Due to Wrong Use of Insecticide.
abstract: We report a noteworthy case of a 7-month-old infant who suddenly and unexpectedly died during her sleep. After a complete postmortem examination, review of the clinical history, and detailed death scene investigation, the death remained unexplained, leading to a diagnosis of sudden infant death syndrome. However, an extensive review of the brainstem neuropathology revealed a severe alteration in the area postrema (a highly vascular structure lying at the base of the fourth ventricle outside of the blood-brain barrier). The alteration was likely due to massive and repeated to a common household insecticide in the last few weeks of life. These results provide an explanation for this sudden infant death, allowing a differential diagnosis from sudden infant death syndrome.
authors.affiliation: "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy; anna.lavezzi@unimi.it.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Lavezzi
authors.affiliation: LC-MS Laboratory, DiSTeVA, University of Urbino, Urbino, Italy; and.
authors.forename: Achille
authors.initials: A
authors.lastname: Cappiello
authors.affiliation: LC-MS Laboratory, DiSTeVA, University of Urbino, Urbino, Italy; and.
authors.forename: Veronica
authors.initials: V
authors.lastname: Termopoli
authors.affiliation: Institute of Anatomic Pathology, Hospital of Lecco, Lecco, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bonoldi
authors.affiliation: "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy;
authors.forename: Luigi
authors.initials: L
authors.lastname: Matturri
mesh_terms: D031608:Area Postrema / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000506:poisoning*; D009596:Nitrophenols / Q000506:poisoning*; D013398:Sudden Infant Death / Q000175:diagnosis / Q000209:etiology*
chemical_list: C480798:2,6-di-tert-butyl-4-nitrophenol; D007306:Insecticides; D009596:Nitrophenols