Forensic Investigation in Anaphylactic Deaths
نویسندگان
چکیده
The anaphylaxis is an allergic reaction. An allergic reaction is a spontaneous and exaggerate reaction of the body to a particular substance. These substances, called allergens, cause production of antibodies when enter the body. The exposition with the substance happens by inhalation, ingestion, contact or inoculation of the allergen. Every substance can act as allergen. Among the more frequent substances we remember the heterologous proteins (hormone like insulin, vasopressin, parathormon; enzymes like trypsin, chemotrypsin, penicillinases; pollens, food like eggs, fish, hazel-nuts, cereals, beans, chocolate; antiserums, hymenoptera venom); polysaccharides (iron dextran); drugs (antibiotics like penicillins, cephalosporins, Amphotericin B, nitrofurantoin, local anesthetics like procaine and lidocaine; vitamins like thiamine and folic acid); diagnostic substances (iodated means of contrast, sodium dehydrocoled, sulfobromoftaleine); industrial chemical products (ethylene oxide). (Fauci et al., 2009) The concept of anaphylaxis comes from the study of the actinotoxins on the dogs’ arterial blood pressure (Richet, 1902). It is well known that the anaphylactic shock is an example of the immediate type of hypersensitivity reaction inducing a diffuse organ hypoperfusion. It has been defined (Delage & Irey, 1972) as the failure of the peripheral circulation induced by an antigen (allergen)-antibody reaction in already sensitized subjects for a foreign substance. Whenever the hypoperfusion is complicated by increased capillary permeability, a rapidly irreversible circulatory fatal damage occurs (anaphylactic death). Delage and Irey (Delage & Irey, 1972), in their clinico-pathological study of 43 validated cases of drug-induced fatal anaphylactic shock, the predominant role of penicillin, subsequently confirmed (Di Maio & Di Maio 2001; Menchel et al., 1987; Weeden, 1988), is
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