Verification of our proposal of sudden infant death syndrome (SIDS) diagnosis

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There are many sudden unexpected infant death cases which are easily diagnosed as sudden infant death syndrome (SIDS) both with or without autopsy in Japan and a easy SIDS diagnosis may provide a cover for accidental or criminal death. Therefore we proposed criteria for a forensic pathological SIDS diagnosis, that is, SIDS should be diagnosed only on the basis of thorough autopsy, death scene investigation and complete rule out of suspicion of accidental or criminal death. The purpose of present study was to verify our criteria in the autopsy cases of sudden infant death, retrospectively and prospectively. Retrospective investigation revealed that only 14 cases of 307 forensic autopsy cases of sudden infant death, in which 122 cases were diagnosed SIDS as the cause of death, should be SIDS as the cause of death according to the criteria.. Our proposal of the criteria may contribute to the recent decrease of SIDS diagnosis in Japan with or without autopsy. As special communications we studied on analysis of autopsy findings, such as organ weight, the existence of petechial bleedings, immunohistochemical analysis of 1 50-kDa oxygen regulated protein, KL-6, pulmonary surfactant-associated protein A in the lung from sudden infant death cases and on the biochemical analysis of postmortem biochemical markers for differential diagnosis between asphyxation death and pulmonary infection death.