Pulmonary capillaritis as a cause of lethal diffuse alveolar hemorrhage

Area of Science:

• Forensic Medicine
• Pathology
• Toxicology

Background:

• Lethal pulmonary hemoptysis is a significant finding in forensic medicine, often presenting with nonspecific preceding symptoms or absent external signs.
• Differential diagnosis for acute alveolar hemorrhage includes traumatic, substance-related, infectious, and organic causes, with cocaine use and drug reactions being prominent.
• Sudden, unexpected deaths necessitate comprehensive post-mortem investigations to identify underlying causes, especially when typical indicators are absent.

Purpose of the Study:

• To present two cases of sudden, unexpected death in women with similar clinical and autopsy findings.
• To investigate the potential association between acute diffuse pulmonary hemorrhage, acute inflammation of lung capillaries, and recent vaccination history.
• To emphasize the critical role of complete autopsy, including toxicological and histological analyses, in identifying rare or unknown causes of death.

Main Methods:

• Case presentation of two deceased women with sudden, unexpected deaths.
• Detailed post-mortem examination, including autopsy, histological, and toxicological analyses.
• Review of medical history, focusing on recent vaccinations and potential exposures.

Main Results:

• Both cases exhibited sudden, unexpected deaths with similar anamnesis.
• Autopsies revealed acute diffuse pulmonary hemorrhage attributed to acute inflammation of lung capillaries.
• One deceased individual had received a COVID-19 vaccination a few months prior to death.

Conclusions:

• Acute diffuse pulmonary hemorrhage caused by acute inflammation of lung capillaries can lead to sudden, unexpected death.
• The findings underscore the necessity of comprehensive autopsies, including toxicology and histology, for diagnosing rare causes of death.
• Documentation and publication of such rare cases are crucial for medical research to explore potential unknown associations, such as with recent vaccinations.