Abstract
In a series of 24 consecutive cases of Sudden Infant Death Syndrome (SIDS) the lungs of 10 infants showed foci of haemosiderin-laden macrophages in the interstitial and subpleural tissue without extravasated red cells nearby, indicating that petechial haemorrhages had occurred at some time prior to the last and fatal event. These lungs were free from inflammatory changes and therefore can be considered to be true cases of SIDS. In contrast the lungs of 11 infants showed inflammatory changes including bronchiolitis and interstitial pneumonia. The remaining 3 infants showed both inflammatory changes and interstitial haemosiderin in macrophages without red cells in the proximity. Fresh petechiae and alveolar haemorrhage sometimes with haemosiderin-laden macrophages are seen in all groups. It is suggested that in true SIDS the lungs are not only free from inflammatory changes, but also show signs of previous events causing petechial haemorrhages, for example near-miss episodes. Haemosiderin-containing macrophages in the interstitium, without free red cells nearby may be the mark of such an event.
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Stewart, S., Fawcett, F. Haemosiderin-laden mescrophages in the interstitial tissue of the lung of sudden infant death cases – a mark of previous “near-miss” events?. Pediatr Res 18, 809 (1984). https://doi.org/10.1203/00006450-198408000-00100
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DOI: https://doi.org/10.1203/00006450-198408000-00100