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Published in: International Journal of Legal Medicine 2/2005

01-03-2005 | Case Report

Heat stroke in an incubator: an immunohistochemical study in a fatal case

Authors: Vittorio Fineschi, Stefano D’Errico, Margherita Neri, Fernando Panarese, Pietro A. Ricci, Emanuela Turillazzi

Published in: International Journal of Legal Medicine | Issue 2/2005

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Abstract

The authors report the unique case of an 8-day-old infant succumbing to heat stroke caused by an abnormal increase of the environmental temperature in an incubator. At postmortem examination, second-degree burns were detected, and macroscopic and microscopic findings were typical for a heat-related death. An immunohistochemical study was performed. At the same time, a detailed examination of the incubator was conducted, revealing a malfunctioning of the temperature and relative humidity control system. We suggest that the diagnosis of heat stroke has to be confirmed on the basis of a detailed postmortem examination and a complete immunohistochemical investigation of heat shock proteins, molecules produced acutely in response to heat stress.
Literature
1.
go back to reference Krous HF, Nadeau JM, Fukumoto RI, Blackbourne BD, Byard RW (2001) Environmental hyperthermic infant and early childhood death circumstances, pathologic changes and manner of death. Am J Forensic Med Pathol 22:374–382PubMed Krous HF, Nadeau JM, Fukumoto RI, Blackbourne BD, Byard RW (2001) Environmental hyperthermic infant and early childhood death circumstances, pathologic changes and manner of death. Am J Forensic Med Pathol 22:374–382PubMed
2.
go back to reference Surpure JS (1982) Heat-related illness and the automobile. Ann Emerg Med 11:263–265PubMed Surpure JS (1982) Heat-related illness and the automobile. Ann Emerg Med 11:263–265PubMed
3.
go back to reference Hiss J, Kahana T, Kugel C, Epstein Y (1994) Fatal classic and exertional heat stroke—report of four cases. Med Sci Law 34:339–343PubMed Hiss J, Kahana T, Kugel C, Epstein Y (1994) Fatal classic and exertional heat stroke—report of four cases. Med Sci Law 34:339–343PubMed
4.
go back to reference Roberts KB, Roberts EC (1976) The automobile and heat stress. Pediatrics 58:101–104PubMed Roberts KB, Roberts EC (1976) The automobile and heat stress. Pediatrics 58:101–104PubMed
5.
go back to reference Wadlington WB, Tucker AL, Fly F, Greene HL (1976) Heat stroke in infancy. Am J Dis Child 130:1250–1251PubMed Wadlington WB, Tucker AL, Fly F, Greene HL (1976) Heat stroke in infancy. Am J Dis Child 130:1250–1251PubMed
6.
go back to reference Chao TC, Sinniah R, Pakiam JE (1981) Acute heat stroke deaths. Pathology 13:145–156PubMed Chao TC, Sinniah R, Pakiam JE (1981) Acute heat stroke deaths. Pathology 13:145–156PubMed
7.
go back to reference Lifschultz BD, Donoghue ER (1998) Forensic pathology of heat and cold-related injuries. Clin Lab Med 18:77–90PubMed Lifschultz BD, Donoghue ER (1998) Forensic pathology of heat and cold-related injuries. Clin Lab Med 18:77–90PubMed
8.
go back to reference Ohshima T, Maeda H, Takayasu T, Fujioka Y, Nakaya T (1992) An autopsy case of infant death due to heat stroke. Am J Forensic Med Pathol 13:217–221PubMed Ohshima T, Maeda H, Takayasu T, Fujioka Y, Nakaya T (1992) An autopsy case of infant death due to heat stroke. Am J Forensic Med Pathol 13:217–221PubMed
9.
go back to reference Bacon CJ (1983) Over-heating in infancy. Arch Dis Child 58:673–674PubMed Bacon CJ (1983) Over-heating in infancy. Arch Dis Child 58:673–674PubMed
10.
go back to reference Kleemann WJ, Schlaud M, Fieguth A, Hiller AS, Rothämel T, Tröger HD (1998) Body and head position, covering of the head by bedding and risk of sudden infant death (SID). Int J Legal Med 112:22–26CrossRef Kleemann WJ, Schlaud M, Fieguth A, Hiller AS, Rothämel T, Tröger HD (1998) Body and head position, covering of the head by bedding and risk of sudden infant death (SID). Int J Legal Med 112:22–26CrossRef
11.
go back to reference Viret J, Tela L, Canini F, Bourdon L (2000) Hydrodynamic model of heat stroke. Acta Biotheor 48:259–272PubMed Viret J, Tela L, Canini F, Bourdon L (2000) Hydrodynamic model of heat stroke. Acta Biotheor 48:259–272PubMed
12.
go back to reference Guntheroth WG, Spiers SP (2001) Thermal stress in sudden infant death: is there an ambiguity with the rebreathing hypothesis? Pediatrics 107:693–698PubMed Guntheroth WG, Spiers SP (2001) Thermal stress in sudden infant death: is there an ambiguity with the rebreathing hypothesis? Pediatrics 107:693–698PubMed
13.
go back to reference Donoghue ER, Graham MA, Lifschultz BD, Luke JL, Mirchandani HG (1997) Criteria for the diagnosis of heat-related deaths: National Association of Medical Examiners. Am J Forensic Med Pathol 18:11–17PubMed Donoghue ER, Graham MA, Lifschultz BD, Luke JL, Mirchandani HG (1997) Criteria for the diagnosis of heat-related deaths: National Association of Medical Examiners. Am J Forensic Med Pathol 18:11–17PubMed
14.
go back to reference Schuliar Y, Savourey G, Besnard Y, Launey JC (2001) Diagnosis of heat stroke in forensic medicine. Contribution of thermophysiology. Forensic Sci Int 124:205–208CrossRefPubMed Schuliar Y, Savourey G, Besnard Y, Launey JC (2001) Diagnosis of heat stroke in forensic medicine. Contribution of thermophysiology. Forensic Sci Int 124:205–208CrossRefPubMed
15.
go back to reference American Academy of Pediatrics—Committee on Sports Medicine and Fitness (2000) Climatic heat stress and the exercising child and adolescent. Pediatrics 106:158–159CrossRefPubMed American Academy of Pediatrics—Committee on Sports Medicine and Fitness (2000) Climatic heat stress and the exercising child and adolescent. Pediatrics 106:158–159CrossRefPubMed
16.
go back to reference King K, Negus K, Vance JC (1981) Heat stress in motor vehicles: a problem in infancy. Pediatrics 68:579–582PubMed King K, Negus K, Vance JC (1981) Heat stress in motor vehicles: a problem in infancy. Pediatrics 68:579–582PubMed
17.
18.
go back to reference Simpson SA, Alexander DJ, Reed CJ (2004) Heat shock protein 70 in the rat nasal cavity: localisation and response to hyperthermia. Arch Toxicol 78:344–350CrossRefPubMed Simpson SA, Alexander DJ, Reed CJ (2004) Heat shock protein 70 in the rat nasal cavity: localisation and response to hyperthermia. Arch Toxicol 78:344–350CrossRefPubMed
19.
go back to reference Martinez J, Perez-Serrano J, Bernadina WE, Rodriguez-Caabeiro F (2001) HSP 60, HSP 70 and HSP 90 for Trichinella spiralis as targets of humoral immune response in rats. Parasitol Res 87:453–458CrossRefPubMed Martinez J, Perez-Serrano J, Bernadina WE, Rodriguez-Caabeiro F (2001) HSP 60, HSP 70 and HSP 90 for Trichinella spiralis as targets of humoral immune response in rats. Parasitol Res 87:453–458CrossRefPubMed
20.
go back to reference Zhang M, Hisaeda H, Kano S et al. (2001) Antibodies specific for heat shock proteins in human and murine malaria. Microbes Infect 3:363–367PubMed Zhang M, Hisaeda H, Kano S et al. (2001) Antibodies specific for heat shock proteins in human and murine malaria. Microbes Infect 3:363–367PubMed
21.
go back to reference Missotten GS, Journee-de Korver JG, Wolff-Rouendaal D de, Keunen JE, Schlingemann RO, Jager MJ (2003) Heat shock protein expression in the eye and in uveal melanoma. Invest Ophthalmol Vis Sci 44:3059–3065CrossRefPubMed Missotten GS, Journee-de Korver JG, Wolff-Rouendaal D de, Keunen JE, Schlingemann RO, Jager MJ (2003) Heat shock protein expression in the eye and in uveal melanoma. Invest Ophthalmol Vis Sci 44:3059–3065CrossRefPubMed
22.
go back to reference Elpek GA, Karaveli S, Simsek T, Keles N, Aksoy NH (2003) Expression of heat-shock proteins hsp 27, hsp 70 and hsp 90 in malignant epithelial tumor of the ovaries. APMIS 111:523–530CrossRefPubMed Elpek GA, Karaveli S, Simsek T, Keles N, Aksoy NH (2003) Expression of heat-shock proteins hsp 27, hsp 70 and hsp 90 in malignant epithelial tumor of the ovaries. APMIS 111:523–530CrossRefPubMed
23.
go back to reference Chi NC, Karliner JS (2004) Molecular determinants of responses to myocardial ischemia/reperfusion injury: focus on hypoxia-inducible and heat shock factors. Cardiovasc Res 61:437–447CrossRefPubMed Chi NC, Karliner JS (2004) Molecular determinants of responses to myocardial ischemia/reperfusion injury: focus on hypoxia-inducible and heat shock factors. Cardiovasc Res 61:437–447CrossRefPubMed
24.
go back to reference Gao Y, Shan YQ, Pan MX, Wang Y, Tang LJ, Li H, Zhang Z (2004) Protein kinase C-dependent activation of P44/42 mitogen-activated protein kinase and heat shock protein 70 in signal transduction during hepatocyte ischemic preconditioning. World J Gastroenterol 10:1019–1027PubMed Gao Y, Shan YQ, Pan MX, Wang Y, Tang LJ, Li H, Zhang Z (2004) Protein kinase C-dependent activation of P44/42 mitogen-activated protein kinase and heat shock protein 70 in signal transduction during hepatocyte ischemic preconditioning. World J Gastroenterol 10:1019–1027PubMed
25.
go back to reference Diao L, Li C, Sheng Z (2000) The significance of the expression of the HSP 70 and HSP 90 in the intestinal mucosa in scalded rats during early postburn stage. Zhonghyìua Shao Shang ZA Zhi 130:279–282 Diao L, Li C, Sheng Z (2000) The significance of the expression of the HSP 70 and HSP 90 in the intestinal mucosa in scalded rats during early postburn stage. Zhonghyìua Shao Shang ZA Zhi 130:279–282
26.
go back to reference Fineschi V, Baroldi G, Centini F et al. (2001) Markers of cardiac oxidative stress and altered morphology after intraperitoneal cocaine injection in a rat model. Int J Legal Med 114:323–330CrossRefPubMed Fineschi V, Baroldi G, Centini F et al. (2001) Markers of cardiac oxidative stress and altered morphology after intraperitoneal cocaine injection in a rat model. Int J Legal Med 114:323–330CrossRefPubMed
27.
go back to reference Doménech P, Carbonell L, Pérez Càrceles MD, Falcòn M, Luna A, Osuna E (2004) Application of postmortem lipid peroxidation in heart tissue to the diagnosis of myocardial damage. Int J Legal Med 118:19–23CrossRefPubMed Doménech P, Carbonell L, Pérez Càrceles MD, Falcòn M, Luna A, Osuna E (2004) Application of postmortem lipid peroxidation in heart tissue to the diagnosis of myocardial damage. Int J Legal Med 118:19–23CrossRefPubMed
28.
29.
go back to reference Li PL, Chao YM, Chan SHH, Chan JYH (2001) Potentiation of baroreceptor reflex response by heat shock protein 70 in nucleus tractus solitarii confers cardiovascular protection during heatstroke. Circulation 103:2114–2119PubMed Li PL, Chao YM, Chan SHH, Chan JYH (2001) Potentiation of baroreceptor reflex response by heat shock protein 70 in nucleus tractus solitarii confers cardiovascular protection during heatstroke. Circulation 103:2114–2119PubMed
Metadata
Title
Heat stroke in an incubator: an immunohistochemical study in a fatal case
Authors
Vittorio Fineschi
Stefano D’Errico
Margherita Neri
Fernando Panarese
Pietro A. Ricci
Emanuela Turillazzi
Publication date
01-03-2005
Publisher
Springer-Verlag
Published in
International Journal of Legal Medicine / Issue 2/2005
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-004-0498-4

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