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.
A physician survey documented 32 anaphylactic deaths attributed to fire ant stings in patients 16 months to 65 years of age.