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NCJ Number: 222360 Find in a Library
Title: Sarcoidosis and Mechanisms of Unexpected Death
Journal: Journal of Forensic Sciences  Volume:53  Issue:2  Dated:March 2008  Pages:460-464
Author(s): Roger W. Byard M.D.; Nicholas Manton F.R.C.P.A.; Michael Tsokos M.D.
Date Published: March 2008
Page Count: 5
Type: Case Study
Format: Article
Language: English
Country: United States of America
Annotation: Two cases of unexpected death due to sarcoidosis illustrate different pathological features of sarcoidosis, one involving cardiac sarcoidosis and the other involving neurosarcoidosis with hypothalamic infiltration.
Abstract: Sarcoidosis is a chronic inflammatory disease of uncertain etiology that involves a variety of organ systems. It was first described in 1869 by Hutchinson in a patient with characteristic skin lesions. The name sarcoid was coined by Boeck in 1899 due to the resemblance of the lesions to sarcomas, a term derived from the Greek "sarcos" for flesh and "eidos," meaning form. The two cases described are among the rare incidences in which sarcoidosis contributed to unexpected death. In one case, a 65-year-old woman with a history of hypertension and ischemic heart disease collapsed and died after an episode of vertigo. At autopsy, significant findings were limited to the cardiovascular system. There was marked fibrous scarring and mottling of the anterior left ventricular free wall and the intraventricular septum that on histology was shown to be composed of noncaseating loosely aggregated epithelioid granulomas typical of sarcoidosis. Granulomas were also present in the lungs. Death was attributed to cardiac sarcoidosis, complicating ischemic and hypertensive cardiac disease. In the second case, a 56-year-old woman with a history of polydipsia, polyphagia with marked weight gain, somnolence, and hypothermia was brought to a hospital with an altered conscious state and leg weakness. She died suddenly in the hospital while eating a meal. At autopsy, significant findings were limited to the upper airway and brain. A bolus of vegetable matter occluded the laryngeal inlet, and the brain had extensive granulomatous inflammation. There were no granulomas elsewhere in her system. Death was attributed to aspiration of food, complicating polyphagia due to neurosarcoidosis. 2 tables and 41 references
Main Term(s): Criminology; Death investigations
Index Term(s): Autopsy; Diseases; Forensic sciences; Investigative techniques
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