Affection of Enterovirus Infection in Sudden Infant Death Syndrome.

Korean J Leg Med. 2005 Oct;29(2):156-162. Korean.

Department of Forensic Medicine, Pusan National University College of Medicine. gyhuh@pusan.ac.kr

Department of Oral Medicine, Pusan National University College of Dentistry.

Department of Forensic Medicine, Korea University College of Medicine.

Forensic Medicine Division, National Institute of Scientific Investigation Southern District Office.

There are more than 120 different theories on the possible cause of sudden infant death syndrome (SIDS). Recent studies indicate a possible role of infections in SIDS, one of which suggested that a maximum percentage of up to 43.5% of SIDS showed virus-induced myocardial affection. The enterovirus, mainly the cardiotropic coxsackievirus group B, serotypes B1-B5, which causes most of viral myocarditis in infancy, seems to be the most common virus associated with SIDS. The aim of our study was to investigate the enterovirus-induced myocardial affections in cases of SIDS. All 7 cases of postmortem heart samples from SIDS victims were studied. Postmortem heart samples of non-SIDS death in perinatal period, infancy and young childhood, pediatric cases of myocarditis and unnatural death in young adult were served as controls. An immunohistochemical study was performed on all samples using monoclonal mouse anti-enterovirus antibody and anti-LCA with quantification of positive cells. Our results demonstrated that 2 of 7 cases of SIDS showed strong immunoreactivity in the myocardium against antienterovirus antibody and there was more inflammatory cell infiltrate in SIDS cases than controls. Our study suggests that the enteroviral myocardial affection would be a possible role in pathogenesis of SIDS.

Key Words: SIDS, enterovirus, myocardium, immunohistochemistry