Sudden unexpected death due to B-cell acute lymphocytic leukaemia (B-ALL) in a 3-year-old child.

IF 1.5 4区 医学 Q2 MEDICINE, LEGAL
Elke Doberentz, Glen Kristiansen, Marit Bernhardt, Frank Musshoff, Burkhard Madea
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Abstract

Sudden unexpected death due to haematologic disease in children is unusual. A 3-year-old girl had been ill for several weeks, but her parents did not consult a doctor. Her complaints included a cough, fever, vomiting and fatigue. On the day of her death, the girl fell from the toilet and was unresponsive. In hospital, severe dyspnoea and a haemoglobin value of only 1.7 mg/dl were diagnosed, as well as hypothermia and haemorrhaging from mouth and nose. Despite intensive medical care and cardiopulmonary resuscitation, the girl died. Main autopsy findings were severe anaemia and the underlying disease, B-cell acute lymphocytic leukaemia (B-ALL). In particular, liver, spleen, lymph nodes, kidneys and bone marrow showed marked infiltration of atypical mononuclear cells replacing haematopoiesis. Intra-alveolar exudation, consistent with the early phase of acute pneumonia, was identified as cause of death. Toxicological investigations revealed positive findings of morphine (53.3 ng/ml), as well as amphetamine and THC in femoral blood, respectively, in hair samples. This paper discusses the medicolegal implications of the case (omitted duty of care by the parents).

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来源期刊
Forensic Science, Medicine and Pathology
Forensic Science, Medicine and Pathology MEDICINE, LEGAL-PATHOLOGY
CiteScore
3.90
自引率
5.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.
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