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Sudden unexpected death in childhood due to unsuspected diabetes mellitus
1Office of the Coroner of Allegheny County, Pittsburgh, PA 15219.
Insights
Sudden death in children can rarely be caused by undiagnosed type 1 diabetes mellitus. Early diagnosis involves identifying fatty liver and specific pancreatic changes.
Area of Science:
- Pediatric pathology
- Endocrinology
- Sudden death investigations
Background:
- Type 1 diabetes mellitus (formerly insulin-dependent diabetes mellitus) is a chronic autoimmune condition.
- While typically diagnosed in childhood, it can present acutely, sometimes with fatal outcomes.
Observation:
- A previously healthy 11-year-old girl experienced a sudden death following a brief upper respiratory infection.
- Autopsy revealed findings suggestive of undiagnosed diabetes mellitus type 1.
Findings:
- The case highlights a diagnostic pathway for type 1 diabetes mellitus, starting with the identification of vesicular fatty liver.
- Specific pancreatic histological and histochemical changes confirmed the diagnosis.
Implications:
- This case underscores the importance of considering diabetes mellitus type 1 in the differential diagnosis of sudden death in children.
- Recognizing early indicators like fatty liver can aid in timely diagnosis and potentially prevent fatal outcomes.
Abstract:
We report the case of an otherwise healthy 11-year-old girl who died suddenly of previously undiagnosed diabetes mellitus type I, following a 2-day minor upper respiratory infection. Insulin dependent diabetes mellitus (IDDM) is a rare cause of sudden death of apparently healthy children. This report demonstrates a recommended diagnostic pathway for IDDM from the substantiation of vesicular fatty liver to specific pancreatic histological and histochemical changes.