Key result
Enterovirus was detected in 12.5% of sudden unexpected death victims compared to 0% of control subjects, demonstrating a higher prevalence of viral myocarditis in sudden death cases.
Why the study?
Is enteroviral myocarditis more prevalent in sudden unexpected death victims compared to controls when assessed by immunohistochemistry and molecular pathology?
Case-Control (n=85)
Yes
Is enteroviral myocarditis more prevalent in sudden unexpected death victims compared to controls when assessed by immunohistochemistry and molecular pathology?
Supplementing conventional histopathology with immunohistochemistry and molecular pathology reveals a significant prevalence of enteroviral myocarditis in young male victims of sudden unexpected death.
Answers are grounded in this paper and cite their sources.
May support enterovirus role in sudden death; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Viral myocarditis is a major cause of sudden unexpected death in children and young adults. Until recently, coxsackievirus B3 (CVB3) has been the most commonly implicated virus in myocarditis. At present, no standard diagnosis is generally accepted due to the insensitivity of traditional diagnostic tests. This has prompted health professionals to seek new diagnostic approaches, which resulted in the emergence of new molecular pathological tests and a more detailed immunohistochemical and histopathological analysis. When supplemented with immunohistochemistry and molecular pathology, conventional histopathology may provide important clues regarding myocarditis underlying etiology. METHODS: This study is based on post-mortem samples from sudden unexpected death victims and controls who were investigated prospectively. Immunohistochemical investigations for the detection of the enteroviral capsid protein VP1 and the characterization and quantification of myocardial inflammatory reactions as well as molecular pathological methods for enteroviral genome detection were performed. RESULTS: Overall, 48 sudden unexpected death victims were enrolled. As for controls, 37 cases of unnatural traffic accident victims were studied. Enterovirus was detected in 6 sudden unexpected death cases (12.5 %). The control samples were completely enterovirus negative. Furthermore, the enteroviral capsid protein VP1 in the myocardium was detected in enterovirus-positive cases revealed by means of reverse transcriptase-polymerase chain reaction (RT-PCR). Unlike control samples, immunohistochemical investigations showed a significant presence of T and B lymphocytes in sudden unexpected death victims. CONCLUSIONS: Our findings demonstrate clearly a higher prevalence of viral myocarditis in cases of sudden unexpected death compared to control subjects, suggesting that coxsackie B enterovirus may contribute to myocarditis pathogenesis significantly.
No takes yet. Share an insight, caveat, or question.
Gaâloul et al. (2012) conducted a case-control in Sudden unexpected death with suspected inflammatory heart disease (n=85). Post-mortem histopathological, immunohistochemical, and molecular pathology evaluation vs. Unnatural traffic accident victims (Controls) was evaluated on Detection of enterovirus by RT-PCR and immunohistochemistry. Enterovirus was detected in 12.5% of sudden unexpected death victims compared to 0% of control subjects, demonstrating a higher prevalence of viral myocarditis in sudden death cases.
Synapse has enriched 10 related papers. Consider them for comparative context: