Atypical drowning due to anaphylactic shock

作者：Ondruschka B^*; Habeck J O; Schwarz M; Dressler J; Bayer R

来源：Rechtsmedizin, 2016, 26(2): 124-128.

DOI：10.1007/s00194-015-0058-x

• Anaphylaxis
• Insect venom
• Postmortem biochemical analysis
• Immunohistochemistry
• Allergy

Anaphylactic shock is a life-threatening allergic reaction. Its incidence as a direct cause of death is very low; however, non-natural causes of death caused by an anaphylactic reaction are rarely documented in statistical evaluations. Surprisingly, to date, cases of drowning due to allergic shock have not been published.
We report the case of a young man who was found lying prone in a small river. A distinct laryngeal edema was detected during autopsy alongside typical signs of drowning. Additionally, it was determined that he had almost suffocated after a wasp sting 1 year before his death. Significantly increased values of tryptase and immunoglobulin E in serum were detected via postmortem biochemical analysis and many degranulated mast cells in heart and lung tissue were seen at immunohistochemical examination. The cause of death was diagnosed as atypical drowning due to anaphylactic shock.
Routine forensic investigations should include the determination of any known allergies and the circumstances of death in every case of suspected anaphylaxis. The results of additional postmortem examinations should be interpreted in the context of the findings from investigative and autopsy studies.

• 出版日期2016-4