Sudden unexpected death associated with lymphocytic thyroiditis

Vibeke Vestergaard, Dorthe Høj Drostrup, Jørgen L Thomsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

 
Udgivelsesdato: 2007-Apr
OriginalsprogEngelsk
TidsskriftMedicine, Science and the Law
Vol/bind47
Udgave nummer2
Sider (fra-til)125-133
Antal sider8
ISSN0025-8024
StatusUdgivet - 1. apr. 2007

Fingeraftryk

Sudden Death
cause of death
Disease
death
Cause of Death
addiction
Group
subversion
alcoholism
Hematoxylin
abuse
Alcoholics
Eosine Yellowish-(YS)
Plasma Cells
alcohol
Poisoning
Alcoholism
Microscopy
examination
Epithelium

Citer dette

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title = "Sudden unexpected death associated with lymphocytic thyroiditis",
abstract = "A forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death. The five groups selected consecutively were: (i) opiate addicts who died from an overdose, (ii) alcoholics who died as a result of their alcohol abuse, (iii) cases of fatal poisoning other than opiate addicts, (iv) unknown cause of death and (v) controls without prior disease. Tissue samples from the thyroid gland were cut and stained with haematoxylin and eosin and van Gieson. Histology examinations were subsequently performed blind with semiquantitative assessment of the following six parameters: (a) height of the follicular epithelium, (b) the amount of lymphocytes, (c) the presence of plasma cells, (d) hyperplastic follicular changes, (e) oxyphilic changes, and (f) fibrosis. The most striking result was the finding of extensive lymphocytic infiltration of the thyroid parenchyma in five of the 124 cases, of which four belonged in the group of 'unknown cause of death'. This discovery leads to reflections regarding lymphocytic thyroiditis as a cause of death, either by itself or in combination with other disorders. Silent (painless) thyroiditis, especially, is easily overlooked at autopsy as there are no macroscopic changes and often no prior symptoms or history of thyroid disease pointing towards this condition. Analyses of thyroid hormones are unreliable in predicting endocrine status in life. Routine microscopy of the thyroid gland is therefore advocated in cases of sudden unexpected death in order to diagnose thyroid disease, in particular silent (painless) thyroiditis.",
keywords = "Adult, Aged, Aged, 80 and over, Autopsy, Death, Sudden, Denmark, Female, Humans, Male, Middle Aged, Retrospective Studies, Thyroiditis, Autoimmune",
author = "Vibeke Vestergaard and Drostrup, {Dorthe H{\o}j} and Thomsen, {J{\o}rgen L}",
year = "2007",
month = "4",
day = "1",
language = "English",
volume = "47",
pages = "125--133",
journal = "Medicine, Science and the Law",
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Sudden unexpected death associated with lymphocytic thyroiditis. / Vestergaard, Vibeke; Drostrup, Dorthe Høj; Thomsen, Jørgen L.

I: Medicine, Science and the Law, Bind 47, Nr. 2, 01.04.2007, s. 125-133.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Sudden unexpected death associated with lymphocytic thyroiditis

AU - Vestergaard, Vibeke

AU - Drostrup, Dorthe Høj

AU - Thomsen, Jørgen L

PY - 2007/4/1

Y1 - 2007/4/1

N2 - A forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death. The five groups selected consecutively were: (i) opiate addicts who died from an overdose, (ii) alcoholics who died as a result of their alcohol abuse, (iii) cases of fatal poisoning other than opiate addicts, (iv) unknown cause of death and (v) controls without prior disease. Tissue samples from the thyroid gland were cut and stained with haematoxylin and eosin and van Gieson. Histology examinations were subsequently performed blind with semiquantitative assessment of the following six parameters: (a) height of the follicular epithelium, (b) the amount of lymphocytes, (c) the presence of plasma cells, (d) hyperplastic follicular changes, (e) oxyphilic changes, and (f) fibrosis. The most striking result was the finding of extensive lymphocytic infiltration of the thyroid parenchyma in five of the 124 cases, of which four belonged in the group of 'unknown cause of death'. This discovery leads to reflections regarding lymphocytic thyroiditis as a cause of death, either by itself or in combination with other disorders. Silent (painless) thyroiditis, especially, is easily overlooked at autopsy as there are no macroscopic changes and often no prior symptoms or history of thyroid disease pointing towards this condition. Analyses of thyroid hormones are unreliable in predicting endocrine status in life. Routine microscopy of the thyroid gland is therefore advocated in cases of sudden unexpected death in order to diagnose thyroid disease, in particular silent (painless) thyroiditis.

AB - A forensic autopsy study comprising 125 cases was carried out retrospectively in order to evaluate pathological changes in the thyroid gland in different groups of death. The five groups selected consecutively were: (i) opiate addicts who died from an overdose, (ii) alcoholics who died as a result of their alcohol abuse, (iii) cases of fatal poisoning other than opiate addicts, (iv) unknown cause of death and (v) controls without prior disease. Tissue samples from the thyroid gland were cut and stained with haematoxylin and eosin and van Gieson. Histology examinations were subsequently performed blind with semiquantitative assessment of the following six parameters: (a) height of the follicular epithelium, (b) the amount of lymphocytes, (c) the presence of plasma cells, (d) hyperplastic follicular changes, (e) oxyphilic changes, and (f) fibrosis. The most striking result was the finding of extensive lymphocytic infiltration of the thyroid parenchyma in five of the 124 cases, of which four belonged in the group of 'unknown cause of death'. This discovery leads to reflections regarding lymphocytic thyroiditis as a cause of death, either by itself or in combination with other disorders. Silent (painless) thyroiditis, especially, is easily overlooked at autopsy as there are no macroscopic changes and often no prior symptoms or history of thyroid disease pointing towards this condition. Analyses of thyroid hormones are unreliable in predicting endocrine status in life. Routine microscopy of the thyroid gland is therefore advocated in cases of sudden unexpected death in order to diagnose thyroid disease, in particular silent (painless) thyroiditis.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Autopsy

KW - Death, Sudden

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Thyroiditis, Autoimmune

M3 - Journal article

C2 - 17520957

VL - 47

SP - 125

EP - 133

JO - Medicine, Science and the Law

JF - Medicine, Science and the Law

SN - 0025-8024

IS - 2

ER -