Eosinophilic Infiltration of the Sino-Atrial Node in Sudden Cardiac Death Caused by Long QT Syndrome
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Published:2022-10-01
Issue:19
Volume:23
Page:11666
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ISSN:1422-0067
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Container-title:International Journal of Molecular Sciences
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language:en
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Short-container-title:IJMS
Author:
Grassi SimoneORCID, Campuzano OscarORCID, Coll Mònica, Cazzato FrancescaORCID, Iglesias Anna, Ausania Francesco, Scarnicci Francesca, Sarquella-Brugada GeorgiaORCID, Brugada Josep, Arena Vincenzo, Oliva AntonioORCID, Brugada Ramon
Abstract
Sudden death is defined as the unexpected death of a healthy person that occurs within the first hour of the onset of symptoms or within 24 h of the victim being last seen alive. In some of these cases, rare deleterious variants of genes associated with inherited cardiac disorders can provide a highly probable explanation for the fatal event. We report the case of a 21-year-old obese woman who lost consciousness suddenly in a public place and was pronounced dead after hospital admission. Clinical autopsy showed an inconclusive gross examination, while in the histopathological analysis an eosinophilic inflammatory focus and interstitial fibrosis in the sino-atrial node were found. Molecular autopsy revealed an intronic variant in the KCNQ1 gene (c.683 + 5G > A), classified as likely pathogenic for long QT syndrome according to the guidelines provided by the American College of Medical Genetics and Genomics. Therefore, there were many anomalies that could have played a role in the causation of the sudden death, such as the extreme obesity, the cardiac anomalies and the KNCQ1 variant. This case depicts the difficult interpretation of rare cardiac structural abnormalities in subjects carrying rare variants responsible for inherited arrhythmic disorders and the challenge for the forensic pathologist to make causal inferences in the determinism of the unexpected decease.
Funder
Catholic University of the Sacred Heart
Subject
Inorganic Chemistry,Organic Chemistry,Physical and Theoretical Chemistry,Computer Science Applications,Spectroscopy,Molecular Biology,General Medicine,Catalysis
Reference79 articles.
1. Grassi, S., Vidal, M.C., Campuzano, O., Arena, V., Alfonsetti, A., Rossi, S.S., Scarnicci, F., Iglesias, A., Brugada, R., and Oliva, A. Sudden Death without a Clear Cause after Comprehensive Investigation: An Example of Forensic Approach to Atypical/Uncertain Findings. Diagnostics, 2021. 11. 2. 2015 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death;Priori;Eur. Heart J.,2015 3. The Spectrum of Epidemiology Underlying Sudden Cardiac Death;Hayashi;Circ. Res.,2015 4. Fernández-Falgueras, A., Sarquella-Brugada, G., Brugada, J., Brugada, R., and Campuzano, O. Cardiac Channelopathies and Sudden Death: Recent Clinical and Genetic Advances. Biology, 2017. 6. 5. Incidence of Sudden Cardiac Death in the Young: A Systematic Review;Couper;BMJ Open,2020
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