PMID- 17133035
OWN - NLM
STAT- MEDLINE
DCOM- 20070215
LR  - 20110202
IS  - 0195-7910 (Print)
IS  - 0195-7910 (Linking)
VI  - 27
IP  - 4
DP  - 2006 Dec
TI  - The role of beta-amyloid precursor protein (beta-APP) staining in the 
      neuropathologic evaluation of sudden infant death and in the initiation of 
      clinical investigations of subsequent siblings.
PG  - 340-4
AB  - This report highlights the importance of undertaking immunohistochemical staining 
      of the brains of infants who die unexpectedly, as it may not only assist with the 
      evaluation of the cause of death in an individual infant but may also help with 
      the clinical management of subsequent siblings. A 5-month-old male infant who 
      died suddenly was found to have diffuse beta-amyloid precursor protein (beta-APP) 
      staining in the brain, with no unusual features in his history, death scene 
      examination, routine autopsy dissection, and ancillary tests to suggest any 
      definite cause of death. Due to the beta-APP staining, the possibility of 
      previous episodes of occult trauma, apparent life threatening events (ALTEs), and 
      accidental or inflicted suffocation was raised in the autopsy report. As detailed 
      analyses and investigations provided no supportive evidence for trauma or 
      inflicted injury, hypoxia was clinically considered the most likely cause. 
      Because of these concerns, sleeping oxygen saturation levels were monitored 
      following the birth of a subsequent sibling who had normal APGAR scores and no 
      evidence of any health problems. Oxygen desaturation to 70% occurred in 
      association with a color change while on the postnatal ward, and a subsequent 
      polysomnogram showed multiple episodic significant desaturations to around 80% in 
      association with central apnea. Other testing was unremarkable. These cases 
      demonstrate that beta-APP staining of the brain may not only provide clues as to 
      possible mechanisms of death in pediatric forensic cases but may indicate a need 
      for careful clinical evaluation of subsequent siblings for possible central apnea 
      requiring oxygen therapy.
FAU - Byard, Roger W
AU  - Byard RW
AD  - Forensic Science SA, Adelaide, South Australia, Australia. 
      byard.roger@saugov.sa.gov.au
FAU - Blumbergs, Peter
AU  - Blumbergs P
FAU - Scott, Grace
AU  - Scott G
FAU - Kennedy, J Declan
AU  - Kennedy JD
FAU - Riches, Karen J
AU  - Riches KJ
FAU - Martin, James
AU  - Martin J
FAU - Thompson, Geoffrey N
AU  - Thompson GN
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Am J Forensic Med Pathol
JT  - The American journal of forensic medicine and pathology
JID - 8108948
RN  - 0 (Amyloid beta-Protein Precursor)
SB  - IM
MH  - Amyloid beta-Protein Precursor/*analysis
MH  - Autopsy
MH  - Brain/*metabolism
MH  - Forensic Medicine
MH  - Humans
MH  - Immunohistochemistry
MH  - Infant
MH  - Male
MH  - Oximetry
MH  - Siblings
MH  - Sudden Infant Death/*pathology
EDAT- 2006/11/30 09:00
MHDA- 2007/02/16 09:00
CRDT- 2006/11/30 09:00
PHST- 2006/11/30 09:00 [pubmed]
PHST- 2007/02/16 09:00 [medline]
PHST- 2006/11/30 09:00 [entrez]
AID - 00000433-200612000-00015 [pii]
AID - 10.1097/01.paf.0000248774.62686.8c [doi]
PST - ppublish
SO  - Am J Forensic Med Pathol. 2006 Dec;27(4):340-4. doi: 
      10.1097/01.paf.0000248774.62686.8c.