• Motoki Osawa, Fumiko Satoh, Hidekazu Horiuchi, Wei Tian, Nobuko Kugota, and Iwao Hasegawa.
• Department of Forensic Medicine, Tokai University Faculty of Medicine, Boseidai, Isehara, Kanagawa 259-1193, Japan. osawa@is.icc.u-tokai.ac.jp
• Leg Med (Tokyo). 2008 May 1; 10 (3): 143-7.

AbstractThis report documented three autopsy cases involving fatal shock during intravenous injection of therapeutic and diagnostic agents in a hospital setting. For postmortem diagnosis, clinical laboratory parameters for anaphylaxis, specificity of antibodies for allergens and mast cell numbers in tissue sections were examined. Elevated plasma tryptase levels were evident in the three adult males; two of the three victims displayed elevated IgE levels. However, immunoassay failed to detect antibodies specific to the relevant agent. Double immuno-staining was performed employing anti-tryptase and anti-chymase monoclonal antibodies in order to count mast cells in lung sections. Increased numbers of mast cells were observed in anaphylactic tissues, which was particularly true for chymase-positive cells, in comparison with tissues associated with acute traumatic deaths. In addition to findings at autopsy, positive data obtained by laboratory examinations and immunohistochemical analyses indicated that fatal systemic anaphylaxis occurred during intravenous injection of clinical agents.

41 keywords...

hide…