Blood and urine studies were performed on 30 consecutive infants who came to autopsy in 1963 after sudden unexpected death. In every case, a constellation of anatomic alterations was found which is identical with that seen in experimentally induced anaphylaxis in animals. Urine analyses revealed intense proteinuria at the time of death and the presence of an abnormal urinary compound termed a "nephrosis peptide."
These authors hypothesize a physio logic defect leading to the absorption of undigested protein. This study suggests that this protein, being antigenic, is re sponsible for a lethal anaphylactic reac tion, thereby explaining the sudden death of some infants.
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References
1.
Adams, J.M.: Sudden death in infants due to pneumonia. J. Pediat.23: 189, 1943.
2.
Adelson, L. and Kinney, E.R.: Sudden, unexpected death in infancy and childhood. Pediatrics17: 663, 1956.
3.
American Academy of Pediatrics: Panel discussion on the thymus gland. J. Pediat.14: 534, 1939.
4.
Bowden, K.: Sudden death or alleged suffocation in babies. Med. J. Aust.1: 65, 1950.
5.
Boyd, E.: Growth of the thymus: its relation to status thymolymphaticus. Amer. J. Dis. Child.33: 867, 1927.
6.
Boyd, E.: The weight of the thymus in health and disease. Amer. J. Dis. Child.43: 1162, 1936.
7.
Carr, J.D.: Status thymolymphaticus. J. Pediat.27: I, 1945.
8.
Coe, J.I. and Peterson, R.D.A. : Sudden, unexpected death in infancy and milk sensitivity. J. Lab. Clin. Med.62: 477, 1963.
9.
Coulson, E.J. and Stevens, H.: Quantitative studies in anaphylaxis. Influence of age and body weight of guinea pigs on the sensitizing and shocking dose . J. Immunol.61: 11, 1949.
10.
Dent, C.E.: A study of the behavior of some 60 amino acids and other ninhydrin-reacting substances on the phenol-"collidine" filter paper chromatograms, with notes as to the occurrence of some of them in biological fluids. Biochem. J.43: 169, 1948.
11.
Department of Health, Commonwealth of Kentucky : 1961Vital Statistics Report, p. 4.
12.
Feldman, J.D. , Dietrich, H. and Dixon, F.J.: Experimental glomerulonephritis; III. Pathogenesis of glomerular lesions in nephrotoxic serum nephritis. Lab. Invest.12: 748, 1963.
13.
Goldman, A.L. , Anderson, W.D., Sellers, W.A., Saperstein, S., Knicker, W.T. and Halpern, S.R.: Milk allergy. I. Oral challenge with milk and isolated milk proteins in allergic children. Pediatrics32: 425, 1963.
14.
Gruenwald, P. and Jacobi, M.: Mononuclear pneumonia in sudden death or rapidly fatal illness in infants. J. Pediat.39: 650, 1951.
15.
Gruskay, F.L. and Cooke, R.E.: The gastrointestinal absorption of unaltered protein in normal infants and in infants recovering from diarrhea. Pediatrics16: 763, 1955.
16.
Hammar, J.A.: Die Menschenthymus in Gesundheit und Krankheit. Teil I: Das normale Organ . Z. Mikrosk. anat. Forsch.6: Suppl. 1926.
17.
Hammar, J.A.: Bedeutet Hyperplasie der Thymus Hyperthymie?Klin. Wschr.18: 1452, 1939.
18.
Hammar, D.K. , Vazquez, J.J. and Dixon, F.J.: Nephrotoxic serum nephritis in newborn rats. Lab. Invest.12: 8, 1963.
19.
Hasson, M.W. , Bevans, M. and Seegal, B.C.: Immediate or delayed nephritis in rats produced by duck anti-rat kidney sera. Arch. Path.64: 192, 1957.
20.
Huang, C.C. , Chang, S.C., Lin, Y.C., Chen, K.H. and Hsu, I.K.: Nephrotoxic serum renal disease in the Taiwan monkey. J. Lab. Clin. Med.62: 201, 1963.
21.
Leys, D.: Inheritance of factor causing sudden death in childhood and early adult life . Edinburgh Med. J.57: I, 1950.
22.
Miller, J.F.A.P. : Role of the thymus in immunity. Brit. Med. J.2: 459, 1963.
23.
Morrison, J.E. : Foetal and Neonatal Pathology. St. Louis, C. V. Mosby, 1952, p. 270.
24.
Parrish, W.E. , Barret, A.M., Coombs, R.R., Gunther, M. and Camps, F.E.: Hypersensitivity to milk and sudden death in infancy. Lancet2: 1106, 1960.
25.
Powell, D.E.B. : Non-suppurative lesions in staphylococcal septicemia . J. Path. Bact.82: 141, 1961.
26.
Pritchard, E.: Enlarged suprarenals and sudden death in an infant. Proc. R. Soc. Med.11: 35, 1918.
27.
Salter, J.L.: Protein metabolism. Chap. 45 in: The Physiological Basis of Medical Practice. Eds. Best, C. H. and Taylor, N. B.Baltimore, Md., Williams & Wilkins Co., 1962, p. 773.
28.
Schloss, O.M. and Worthen, T.W.: The permeability of the gastrointestinal tract of infants to undigested protein. Amer. J. Dis. Child.11: 342, 1916.
29.
Spain, D.N. , Bradess, V.A. and Greenblatt , I.J.: Possible factor in sudden and unexpected death during infancy. J. A. M. A.156: 246, 1954.
30.
Stowens, D. : Sudden unexpected death in infancy. Amer. J. Dis. Child.94: 674, 1957.
31.
Stowens, D.: Congenital malformations of the kidney. Presented at Annual Meeting, A. S. C. P, Chicago, III., Oct. 1962.
32.
Symmers, D. : The cause of sudden death in status thynzolymphaticus . Amer, J. Dis. Child.14: 463, 1917.
33.
Tahka, H.: The weight of the thymus in children of 0-2 years of age. Acta paediat.40: 469, 1951.
34.
Valdes-Dapena, M.A., Eichman, M.F. and Ziskin, L.: Sudden, unexpected death in infants. I. Gamma globulin levels in the serum. J. Pediat.63: 290, 1963.
35.
Waldbott, G.L. : So called "thymic death" (6). The pathologic process in 34 cases. Amer. J. Dis. Child.47: 41, 1934.
36.
Werne, J.: Postmortem evidence of acute infection in unexpected death in infancy. Amer. J. Path.18: 759, 1942.
37.
Werne, J. and Garrow, I.: Sudden apparently unexplained death during infancy. Amer. J. Path.29: 633, 1953.
