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Published on: August 7, 2017
Sudden infant death syndrome: a search for allergen hypersensitivity
L L Hagan1, D W Goetz, C H Revercomb
1Allergy-Immunology Department, Wilford Hall Medical Center, Lackland AFB, Texas, USA.
Insights
Anaphylaxis is unlikely to be a common cause of Sudden Infant Death Syndrome (SIDS). This study found no significant difference in allergic markers between SIDS cases and controls, suggesting other factors are at play.
Area of Science:
- Pediatric Pathology
- Allergy and Immunology
- Forensic Medicine
Background:
- Sudden Infant Death Syndrome (SIDS) lacks clear pathological indicators for its cause.
- Previous research on anaphylaxis as a cause of SIDS is limited.
Purpose of the Study:
- To investigate the presence of anaphylaxis markers in infants who died of SIDS.
- To compare allergic responses in SIDS cases versus age-matched controls.
Main Methods:
- Forensic blood samples from 51 SIDS cases and 13 controls were analyzed.
- Tests included total IgE, specific IgE (RAST) for common allergens, and serum tryptase levels.
Main Results:
- Total IgE, serum tryptase levels, and the frequency of positive RAST tests were similar between SIDS cases and controls.
- No statistically significant differences were found in specific IgE responses to any tested allergen.
Conclusions:
- While some SIDS cases showed elevated allergic markers, these were not more frequent than in controls.
- Anaphylaxis is likely an uncommon cause of SIDS.
Background:
Sudden infant death syndrome (SIDS) remains a diagnosis by exclusion which leaves few if any pathologic clues to its etiology. Previous evaluations for anaphylaxis in SIDS have been few and limited.
Objective:
To analyze forensic blood specimens for evidence of anaphylaxis in 51 (43 boys and 8 girls) children dying of SIDS and 13 (9 boys and 4 girls) age-matched controls who died from defined, nonanaphylactic causes.
Methods:
Specimens collected over a 5-year period were assayed for (1) total IgE (IU/mL) by immunoenzymatic assay; (2) latex, cat, dust mite (Dermatophagoides farinae and Dermatophagoides pteronyssinus), milk, soy, wheat, peanuts, egg, and tomato specific-IgE by RAST; and (3) serum tryptase levels (U/L) by radioimmunoassay.
Results:
The 51 SIDS cases (median age 3 months; range 1 to 9 months) and 13 control cases (median age 4 months; range 1 to 11 months) demonstrated similar total IgE of 9.8 +/- 1.1 IU/mL (mean +/- SEM) and 10.9 +/- 2.8 IU/mL (P = .59). The frequency of detectable (> 0.5 U/L) serum tryptase levels among SIDS cases (10/51) was similar to controls (3/13, P = .72). The frequency of positive RAST tests was 39% (20/51) in SIDS and 38% (5/13) in control subjects (P = .99). Differences in frequencies of positive RAST tests in SIDS and control cases were not statistically significant for any allergen tested. The most frequently detected allergen-specific IgE, to milk, was similar in SIDS (22%) and controls (31%, P = .48).
Conclusions:
Elevated tryptase levels and allergen-specific IgE (milk, soy, wheat, peanuts, egg, tomato, dust mites, cat, and latex) were demonstrated in some infant SIDS deaths but were no more common than in controls. We conclude that anaphylaxis is probably an uncommon etiology for SIDS.
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