The sudden and unexpected death of a female-to-male transsexual patient.
The sudden and unexpected death of a female-to-male transsexual patient.
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DOI：
10.1016/j.jcfm.2006.07.012
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发表时间：
2007-08-01
影响因子：
1.5
通讯作者：
Nata, Masayuki
中科院分区：
文献类型：
--
作者：
Inoue, Hiromasa;Nishida, Naoki;Nata, Masayuki
一名32岁的女性，在两年的时间里，每月一次或两次肌肉注射增强睾酮（125毫克）治疗女变男症，突然死亡。进行了法医解剖以调查死因。宏观观察到同心性心肌肥厚。左、右冠状动脉内皮内多见动脉粥样硬化。特别是在左降支起始处存在严重狭窄（>90%）。显微镜下观察到心肌凝固性坏死和收缩带性坏死。弥漫性心肌纤维化和心肌钙化。死因诊断为冠状动脉狭窄引起的缺血性心脏病。关于交叉激素替代是否与冠状动脉疾病的发生有关还存在一些争论，然而，在本病例中，使用睾酮酸可能加剧了缺血性心脏病的发展。
A 32-year-old woman, who was intramuscularly injected with testosterone enanthate (125 mg) once or twice a month over a two-year period for female-to-male transsexualism, died suddenly. A forensic autopsy was performed to investigate the cause of death. Concentric cardiac hypertrophy was macroscopically observed. In the left and right coronary arteries, atherosclerosis was generally observed within the endothelium. In particular, there was severe stenosis (>90%) at the start of the left descending branch. In the myocardium, both coagulation necrosis and contraction band necrosis were microscopically observed. Moreover, myocardial fibrosis and myocardial calcification were diffusely detected, respectively. The cause of death was diagnosed as ischemic heart disease due to coronary stenosis. There is some debate as to whether cross-hormone replacement is related to the occurrence of coronary artery disease or not, however, it is possible that the development of ischemic heart disease was aggravated by the administration of testosterone enanthate in the current case.