anaphylactic death

anaphylactic death

A death resulting from an anaphylactic reaction, which kills by shock or asphyxia, due to an IgE-mediated immune response. Anaphylactic shock may be misdiagnosed as myocardial infarction; food and aspirin anaphylaxis may be misdiagnosed as fatal asthma. Asphyxia may be due to asthma (food or aspirin/NSAID sensitivity) or laryngeal oedema (due to stings, e.g., or bees).
 
Workup
Read notes to identify a sudden collapse following exposure to something—e.g., anaesthetic, certain foods (nuts, shellfish), bee sting, hair dye, etc.

Role of autopsy in suspected anaphylaxis 
• Is there morbid anatomy to support suspected anaphylaxis?
• Is there other morbid anatomy that could account of the death?
• Is there biochemical evidence of anaphylaxis (e.g., mast cell tryptase)?
• Is there serologic evidence of the agent (e.g., specific IgE antibodies)?
References in periodicals archive ?
Anaphylactic deaths in Maryland (United States) and Shanghai (China): a review of forensic autopsy cases from 2004 to 2006.
(The symptoms are the same whatever the cause, but food causes more anaphylactic deaths per year than insect stings.) If epinephrine is not available, and the person is conscious, administering a liquid anthistamine is better than nothing.
A physician survey documented 32 anaphylactic deaths attributed to fire ant stings in patients 16 months to 65 years of age.