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Vocal cord basement membrane in non-sudden infant death syndrome cases
1Disciplina de Patologia, Departamento de Ciências Biológicas, Faculdade de Medicina do Triângulo Mineiro, Praça Manoel Terra s/no, Centro, 38015-050, Uberaba, Minas Gerais, Brazil.
Insights
Vocal cord basement membrane thickening (VCBMT) is common in infant autopsies, often linked to infections, not just sudden infant death syndrome (SIDS). This finding suggests VCBMT is not a specific indicator for SIDS.
Area of Science:
- Pediatric Pathology
- Forensic Medicine
- Histopathology
Background:
- Vocal cord basement membrane thickening (VCBMT) has been noted in sudden infant death syndrome (SIDS) cases.
- VCBMT has been proposed as a potential autopsy indicator for SIDS in unexpected childhood deaths.
Purpose of the Study:
- To analyze vocal cord basement membranes in pediatric autopsies (0-365 days old).
- To investigate the characteristics and prevalence of VCBMT in relation to causes of death.
Main Methods:
- Analysis of 134 pediatric larynges using H&E, PAS, Masson's trichrome, sirius red, and Carstairs staining.
- Immunohistochemistry for collagen IV to characterize VCBMT.
- Morphometric analysis and clinical record review.
Main Results:
- VCBMT was identified in 18.7% of cases.
- VCBMT exhibited normal basement membrane characteristics, including collagen IV immunoreactivity.
- VCBMT occurred in infants dying from various causes, frequently associated with infections, and within the first year of life.
Conclusions:
- VCBMT is a frequent finding in pediatric autopsies.
- VCBMT is not exclusive to SIDS and is often associated with infectious diseases.
- VCBMT occurs in infants during their first year, irrespective of SIDS.
Abstract:
Vocal cord basement membrane thickening (VCBMT) has been observed in children with sudden infant death syndrome (SIDS). It has been proposed that this lesion could be used as a positive indicator of this syndrome in autopsies of children who have died unexpectedly. The present investigation aimed to analyze vocal cord basement membranes from autopsies of children 0 to 365 days old. A total of 134 larynges were analyzed. Histological sections of paraffin-embedded larynges stained with H&E and submitted to histochemical staining with periodic acid-Schiff (PAS), Masson's trichrome, syrius red, and Carstairs were used for light microscopy analysis. Immunohistochemistry with monoclonal anti-collagen IV antibody was used to determine the nature of VCBMT. The study was completed with morphometry of H&E- and PAS-stained sections and revision of the clinical information contained in the hospital files. VCBMT was found in 25 cases (18.7%) and showed characteristics of normal basement membrane, including immunoreactivity to collagen IV. Our data support the conclusions that VCBMT is frequently seen in pediatric autopsies, is seen in children in all age-groups studied whose deaths were due to causes other than SIDS, and is commonly associated with infectious diseases. Like SIDS, VCBMT occurs in the first year of life.