The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies

Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a caus...

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Autores principales:	Romy du Long, Judith Fronczek, Hans W. M. Niessen, Allard C. van der Wal, Hans H. de Boer
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Criminal law and procedure K5000-5582 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/2736ead0c55746c1925bf50348d10584
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spelling	oai:doaj.org-article:2736ead0c55746c1925bf50348d105842021-11-26T11:19:49ZThe histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies2096-17902471-141110.1080/20961790.2021.1989793https://doaj.org/article/2736ead0c55746c1925bf50348d105842021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/20961790.2021.1989793https://doaj.org/toc/2096-1790https://doaj.org/toc/2471-1411Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases. We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death. Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations, the predominant inflammatory cell type, and the presence of inflammation-associated myocyte injury, fibrosis, edema and hemorrhage. Next, the cases were divided over three groups, based on the reported cause of death. Group 1 (n = 27) consisted of all individuals with an obvious unnatural cause of death. Group 2 (n = 29) included all individuals in which myocarditis was interpreted to be one out of more possible causes of death. Group 3 (n = 23) consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy, and no other cause of death was found. Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation (Group 1) or a potentially significant one (Groups 2 and 3). No other histological parameter showed significant differences between the groups. Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a (potentially) significant one.Romy du LongJudith FronczekHans W. M. NiessenAllard C. van der WalHans H. de BoerTaylor & Francis GrouparticleCriminal law and procedureK5000-5582Public aspects of medicineRA1-1270ENForensic Sciences Research, Vol 0, Iss 0, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Criminal law and procedure K5000-5582 Public aspects of medicine RA1-1270
spellingShingle	Criminal law and procedure K5000-5582 Public aspects of medicine RA1-1270 Romy du Long Judith Fronczek Hans W. M. Niessen Allard C. van der Wal Hans H. de Boer The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
description	Interpreting a myocardial inflammation as causal, contributory or as of no significance at all in the cause of death can be challenging, especially in cases where other pathologic and/or medico-legal findings are also present. To further evaluate the significance of myocardial inflammation as a cause of death we performed a retrospective cohort study of forensic and clinical autopsy cases. We revised the spectrum of histological inflammatory parameters in the myocardium of 79 adult autopsy cases and related these to the reported cause of death. Myocardial slides were reviewed for the distribution and intensity of inflammatory cell infiltrations, the predominant inflammatory cell type, and the presence of inflammation-associated myocyte injury, fibrosis, edema and hemorrhage. Next, the cases were divided over three groups, based on the reported cause of death. Group 1 (n = 27) consisted of all individuals with an obvious unnatural cause of death. Group 2 (n = 29) included all individuals in which myocarditis was interpreted to be one out of more possible causes of death. Group 3 (n = 23) consisted of all individuals in which myocarditis was reported to be the only significant finding at autopsy, and no other cause of death was found. Systematic application of our histological parameters showed that only a diffuse increase of inflammatory cells could discriminate between an incidental presence of inflammation (Group 1) or a potentially significant one (Groups 2 and 3). No other histological parameter showed significant differences between the groups. Our results suggest that generally used histological parameters are often insufficient to differentiate an incidental myocarditis from a (potentially) significant one.
format	article
author	Romy du Long Judith Fronczek Hans W. M. Niessen Allard C. van der Wal Hans H. de Boer
author_facet	Romy du Long Judith Fronczek Hans W. M. Niessen Allard C. van der Wal Hans H. de Boer
author_sort	Romy du Long
title	The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
title_short	The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
title_full	The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
title_fullStr	The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
title_full_unstemmed	The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
title_sort	histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/2736ead0c55746c1925bf50348d10584
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The histopathological spectrum of myocardial inflammation in relation to circumstance of death: a retrospective cohort study in clinical and forensic autopsies

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