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Title: Eosinophilic Infiltration of the Sino-Atrial Node in Sudden Cardiac Death Caused by Long QT Syndrome
Author: Grassi, Simone
Campuzano, Òscar
Coll, Mònica
Cazzato, Francesca
Iglesias, Anna
Ausania, Francesco
Scarnicci, Francesca
Sarquella Brugada, Georgia
Brugada Terradellas, Josep, 1958-
Arena, Vicenzo
Oliva, Antonio
Brugada, Ramon
Keywords: Mort sobtada
Genètica humana
Sudden death
Issue Date: 1-Oct-2022
Publisher: MDPI
Abstract: Sudden death is defined as the unexpected death of a healthy person that occurs within the first hour of the onset of symptoms or within 24 h of the victim being last seen alive. In some of these cases, rare deleterious variants of genes associated with inherited cardiac disorders can provide a highly probable explanation for the fatal event. We report the case of a 21-year-old obese woman who lost consciousness suddenly in a public place and was pronounced dead after hospital admission. Clinical autopsy showed an inconclusive gross examination, while in the histopathological analysis an eosinophilic inflammatory focus and interstitial fibrosis in the sino-atrial node were found. Molecular autopsy revealed an intronic variant in the KCNQ1 gene (c.683 + 5G > A), classified as likely pathogenic for long QT syndrome according to the guidelines provided by the American College of Medical Genetics and Genomics. Therefore, there were many anomalies that could have played a role in the causation of the sudden death, such as the extreme obesity, the cardiac anomalies and the KNCQ1 variant. This case depicts the difficult interpretation of rare cardiac structural abnormalities in subjects carrying rare variants responsible for inherited arrhythmic disorders and the challenge for the forensic pathologist to make causal inferences in the determinism of the unexpected decease.
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It is part of: International Journal Of Molecular Sciences, 2022, vol. 23, num. 19
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ISSN: 1422-0067
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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