Splenic hypereosinophilia in anaphylaxis-related death: different assessments depending on different types of allergens?

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• 作者：Luca Reggiani Bonetti (1)
  Livia Maccio (1)
  Nicoletta Trani (2)
  Erjon Radheshi (2)
  Cristian Palmiere (3)
  
• 关键词：Anaphylaxis ; Spleen ; Eosinophils ; Mast cells ; Histology
• 刊名：International Journal of Legal Medicine
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：129
• 期：1
• 页码：97-103
• 全文大小：652 KB
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• 作者单位：Luca Reggiani Bonetti (1)
  Livia Maccio (1)
  Nicoletta Trani (2)
  Erjon Radheshi (2)
  Cristian Palmiere (3)
  
  1. Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia 鈥?Section of Anatomia Patologica, Modena, Italy
  2. Department of Diagnostic Medicine and Public Health, University of Modena and Reggio Emilia 鈥?Section of Medicina Legale, Modena, Italy
  3. University Center of Legal Medicine, Lausanne University Hospital, 21 Rue du Bugnon, 1011, Lausanne, Switzerland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Forensic Medicine
  Medical Law
  Medicine/Public Health, general
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1437-1596

文摘

The aim of this study was to evaluate splenic eosinophil and mast cell accumulation using pagoda red stain in a series of anaphylaxis-related deaths that underwent medico-legal investigations. Our goal was to assess whether fatal reactions to insect stings, intramuscularly administered antibiotics and intravenously injected contrast media are responsible for specific patterns of eosinophil and mast cell accumulation. Two study groups were prospectively formed, an anaphylaxis-related death group and a control group. Autopsy, histology (haematoxylin-eosin stain, pagoda red stain and immunohistochemistry using anti-tryptase antibodies), toxicology and postmortem biochemistry (beta-tryptase, total IgE and specific IgE) were performed in all cases. All tested parameters (spleen weight, beta-tryptase and total IgE levels as well as eosinophil, mast cell and degranulated mast cell numbers in the spleen) were significantly higher in the anaphylaxis-related death group. No statistically significant differences were observed among the various groups (intramuscular antibiotic injection, intravenous contrast medium administration and stinging insects) in any combination, suggesting that mast cell and eosinophil accumulation in the spleen during anaphylaxis does not have any specific pattern related to the triggering allergen. Despite a lower sensitivity than immunohistochemical staining in discriminating eosinophil and mast cells, pagoda red stain allowed these cells to be identified and could therefore be proposed as a low-cost, first-line diagnostic procedure in those situations where immunohistochemistry is not systematically performed or cannot be carried out.