Pancreatic islet abnormalities in sudden infant death syndrome. Qualitative and quantitative analyses of 15 cases

The pancreata of 15 autopsy cases of sudden infant death syndrome (SIDS) and those of 14 age-matched controls were examined qualitatively and quantitatively to re-evaluate the relationship between pancreatic islet abnormalities and sudden death in infancy. Histopathologically, a diffuse or focal form of nesidioblastosis and septal islets were frequently observed in the pancreata of both groups. Endocrine cell dysplasia was found only in 2 infants who had died of SIDS. Quantitatively, there was little difference of islet cell composition between the SIDS cases and the controls. A relatively high proportion of islet cell area to total pancreatic tissue area was demonstrated in the SIDS group (8.46 +/- 4.90% in the pancreatic head; 8.66 +/- 4.23% in the pancreatic body to tail) in comparison with the controls (5.32 +/- 1.77%; 5.63 +/- 1.60%). Although nesidioblastosis and septal islets were considered to be within the limits of normal variation during pancreatic development, endocrine cell dysplasia and quantitatively unusual proliferation of the pancreatic endocrine tissue suggest the possibility that abnormalities in the endocrine pancreas may be causally related to sudden death in infancy.