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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sudden unexpected death related to enterovirus myocarditis: histopathology, immunohistochemistry and molecular pathology diagnosis at post-mortem
BMC Infectious Diseases, Volume 12, Article 212, Year 2012
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Description
Background: Viral myocarditis is a major cause of sudden unexpected death in children and young adults. Until recently, coxsackievirus B3 (CVB3) has been the most commonly implicated virus in myocarditis. At present, no standard diagnosis is generally accepted due to the insensitivity of traditional diagnostic tests. This has prompted health professionals to seek new diagnostic approaches, which resulted in the emergence of new molecular pathological tests and a more detailed immunohistochemical and histopathological analysis. When supplemented with immunohistochemistry and molecular pathology, conventional histopathology may provide important clues regarding myocarditis underlying etiology.Methods: This study is based on post-mortem samples from sudden unexpected death victims and controls who were investigated prospectively. Immunohistochemical investigations for the detection of the enteroviral capsid protein VP1 and the characterization and quantification of myocardial inflammatory reactions as well as molecular pathological methods for enteroviral genome detection were performed.Results: Overall, 48 sudden unexpected death victims were enrolled. As for controls, 37 cases of unnatural traffic accident victims were studied. Enterovirus was detected in 6 sudden unexpected death cases (12.5 %). The control samples were completely enterovirus negative. Furthermore, the enteroviral capsid protein VP1 in the myocardium was detected in enterovirus-positive cases revealed by means of reverse transcriptase-polymerase chain reaction (RT-PCR). Unlike control samples, immunohistochemical investigations showed a significant presence of T and B lymphocytes in sudden unexpected death victims.Conclusions: Our findings demonstrate clearly a higher prevalence of viral myocarditis in cases of sudden unexpected death compared to control subjects, suggesting that coxsackie B enterovirus may contribute to myocarditis pathogenesis significantly. © 2012 Gaaloul et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Gaâloul, Imed
Tunisia, Monastir
Faculty of Pharmacy
United States, Burlington
The University of Vermont
Tunisia, Sousse
Hopital Farhat Hached Sousse
Riabi, Samira
Tunisia, Monastir
Faculty of Pharmacy
Harrath, Rafik
Tunisia, Monastir
Faculty of Pharmacy
Evans, Mark Francis
United States, Burlington
The University of Vermont
Haj Salem, Nidhal
Tunisia, Monastir
Chu Fattouma-bourguiba
Mlayeh, Souheil
Tunisia, Sousse
Hopital Farhat Hached Sousse
Huber, Sally Ann
United States, Burlington
The University of Vermont
Aouni, Mahjoub
Tunisia, Monastir
Faculty of Pharmacy
Statistics
Citations: 43
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2334-12-212
e-ISSN:
14712334
Research Areas
Maternal And Child Health
Study Design
Cross Sectional Study