[Sudden death in rheumatoid arthritis with cervical myelopathy]

The authors describe an uncommon case of sudden death in a 53-year-old female patient with cervical myelopathy associated with rheumatoid arthritis stage IV/C. The patient died six hours after a drop of the blood pressure to undetectable values was found. Malignant hypotension of central origin which could not be influenced by pharmacological treatment was involved. It was due to compression of the upper cervical spine by a partly dislocated dens of the epistropheus and subsequent afferent spinal oedema which affected the vasomotor centre in the brain stem. The clinically suspect cause of death was confirmed by autopsy: Myelogenic shock.