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The difficult diagnosis of cot death
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ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
Pathology (1980), 12, April
moderate mesangial changes in 1 1 of the 15 patients. The intensity of in vivo ANA staining did not correlate directly with either immune complex deposition nor the changes on light microscopy. A normal skin biopsy from each patient was examined and 14 had in vivo ANA. Deposits of immunoglobulins and/or complement were found at dermal-epidermal junction in 11 patients and in dermal blood vessels in 10 patients. Each patient had serum ANA against rat liver cells; 14in high titre (1 in 1000 o r greater). Elevated levels of DNA-binding were found in 10 patients but the level of binding did not correlate directly with the intensity of in vivo ANA staining. Hypocomplementaemia was present in 10 patients. In vivo biopsy ANA staining appears t o be a real phenomenon and not an artifact. The factors which determine its development in SLE are unknown, although it generally indicates active disease.
THE DIFFICULT DIAGNOSIS OF COT DEATH
A. L. W r u r A M s Depurtmmt of Patliology, Royal Children'.s Hospital, Melbourne Statistics are used as an important tool in the epidemiological investigation of cot death. These statistics are entirely dependent on the correct diagnosis being made by the pathologist following necropsy. This diagnosis is not always clear-cut particularly when evidence of respiratory tract infection is present. Illustrative histories are presented and the contribution that respiratory infection makes t o cot death statistics is illustrated by an analysis of Melbourne figures during 1976-7. Analysis of these figures supports the contention that cot death is not a aingle entity.
ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALIA
Pathology (1980), 12, April
moderate mesangial changes in 1 1 of the 15 patients. The intensity of in vivo ANA staining did not correlate directly with either immune complex deposition nor the changes on light microscopy. A normal skin biopsy from each patient was examined and 14 had in vivo ANA. Deposits of immunoglobulins and/or complement were found at dermal-epidermal junction in 11 patients and in dermal blood vessels in 10 patients. Each patient had serum ANA against rat liver cells; 14in high titre (1 in 1000 o r greater). Elevated levels of DNA-binding were found in 10 patients but the level of binding did not correlate directly with the intensity of in vivo ANA staining. Hypocomplementaemia was present in 10 patients. In vivo biopsy ANA staining appears t o be a real phenomenon and not an artifact. The factors which determine its development in SLE are unknown, although it generally indicates active disease.
THE DIFFICULT DIAGNOSIS OF COT DEATH
A. L. W r u r A M s Depurtmmt of Patliology, Royal Children'.s Hospital, Melbourne Statistics are used as an important tool in the epidemiological investigation of cot death. These statistics are entirely dependent on the correct diagnosis being made by the pathologist following necropsy. This diagnosis is not always clear-cut particularly when evidence of respiratory tract infection is present. Illustrative histories are presented and the contribution that respiratory infection makes t o cot death statistics is illustrated by an analysis of Melbourne figures during 1976-7. Analysis of these figures supports the contention that cot death is not a aingle entity.