Sudden death in a case of sickle cell anemia: post-mortem computed tomography and autopsy correlation from a radiologist's perspective.

Sickle cell anemia (SCA) is a hemolytic disease characterized by the production of abnormal hemoglobin chains and distorted red blood cell morphology or sickling. "Sickle cell crisis" includes vaso-occlusive crisis, a plastic crisis, sequestration crisis, haemolytic crisis and often culminating in serious complications, organ damage and even sudden death. Post-mortem computed tomography (PMCT) findings of sickle cell disease have never been reported in literature. This case of sudden death from acute hemolytic crisis in SCA where post-mortem computed tomography (PMCT) and autopsy findings complemented each other, both revealing findings invisible to the other and both crucial to the case.

[Fatal pneumonitis during low-dose methotrexate treatment]. / Tödliche Pneumonitis unter Basistherapie mit Methotrexat.

We present the case of a 71 year old Swiss woman with a symptomatic rheumatic arthritis whose rheumatologist started a therapy with methotrexate. While the symptoms disappeared completely, the woman died about two months later suddenly. By then she got a cumulative dose of 160 mg. The forensic post-mortem examination showed a fibrosing alveolitis. If respiratory symptoms appear under methotrexat regimen therapy, immediate stopping the medication could be life-saving. In accordance to the chest x-ray a cortisone therapy can be established.

HIV-1- prevalence among drug deaths in major cities of central and northern Europe.

Since 1985, a number of Institutes of Forensic Medicine in Germany have cooperated in a multicenter study, to provide a constant monitoring of HIV-1-prevalence among drug related deaths. In 1990/91, the Institutes in Copenhagen, Stockholm, Vienna and Zürich also participated in this study. HIV-1-prevalence is decreasing in the German cities, whereas the epidemiological development is not uniform in the other major cities. Regional differences are obvious. In 1991, the prevalence rates were as follows: Berlin 15% (n = 220), Hamburg 4% (n = 179), Frankfurt 17% (n = 167), Munich 9% (n = 136), Stockholm 10% (n = 79), Copenhagen 14% (n = 130), Vienna 20% (n = 56), and Zürich 23% (n = 84).

Morphologic variations in 180 cases of sudden infant death and 180 controls.

The incidence of morphologic variations (MVs) was investigated in 180 infants who died unexpectedly and suddenly and in 180 age-matched nonsuddenly deceased infants. The same person (G.M.) performed a full postmortem and histologic examination on all of the infants, none of whom had significant malformations. The test group (TG) consisted of 146 infants whose death was unexplained, whereas group 3 (G3) consisted of 34 infants with adequately determined causes of death. The principal findings in the control group were prematurity, inflammatory and metabolic diseases, tumors, and traumatic lesions. MVs were present in 62% of the TG infants, in 47% of the G3 children, and in 22% of the controls. The differences between the TG and G3 on the one hand and the controls on the other are statistically significant (p < 0.001 and 0.05, respectively). In the TG, anomalies were twice, dysplasias three times, and dysmorphisms four times as common as in controls; in G3, four times as many dysplasias and dystropics were found as in controls. In the TG, 23% of the MVs were multiple as compared with 9% in G3 and 5% in controls. The pattern of distribution was not confined to certain organs. Among the relative high percentage of dysplasias, the large number of neuroblastomas is striking.