Ani Bebek Ölümü Sendromu Şüphesi Olan Olgularda Akciğer Dokusunda Bulunan Megakaryosit Sayılarının Değerlendirilmesi
Özet
Sudden Infant Death Syndrome (SIDS) is defined as the sudden and unexplained death of infants aged 8 to 365 days and is the most common cause of postneonatal death in developed countries. Although the etiology is not fully known yet, the underlying cardiac arrhythmogenic mechanisms have gained popularity in recent years. MKs found in the lumen of alveolar capillaries in lung tissue, are regarded as final embolism in cases of shock. In regard to the postmortem findings in adults, dying in a shock situation, there is the hypothesis that MKs were found in lung tissue in an increased number just in cases of a prolonged shock situation. The study is intended to provide information on whether and to what extent shock occurs in suspected SIDS. Thirty-five cases of suspected SIDS (female=10; male=25; mean age=3,11 months) were retrospectively investigated for the presence of MKs in the alveolar capillaries of the lungs. Lung samples from each case of the suspected SIDS victims were microscopically examined, and the number MKs found in the lumen of alveolar capillaries in a total of 25 fields (200x) were counted. 3 controls known to have died by suffocation and 24 controls known to have died of natural causes other than SIDS were also examined for comparison. Among the suspected SIDS cases, 57% of the samples (20 cases) were free of any MKs. 17% of the cases (6 cases) showed only 1 MK, 17% of the cases (6 cases) showed 2 MKs in 25 fields. Number of MKs were greater than 2 in 8,5% of the samples. There was no statistical difference between the rates of MK presence and the number of MKs in the cases in the SIDS and control groups. It is a widely accepted phenomenon in general pathology that MK embolisms in alveolar capillaries are shock equivalents. Findings in this study suggest that the scarceness of MKs in lung tissue is in consistency with the hypothesis that SIDS results from a sudden death, in which the agonal period is very short, such as death by a cardiac arrythmia. Further studies will help evaluate the relationship between the presence of MKs and SIDS.
