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Flomenbaum MA, Warner RC. Morphologic Markers of Acute and Chronic Stress in Child Abuse. Am J Clin Pathol 2022; 157:823-835. [PMID: 34919642 PMCID: PMC9171574 DOI: 10.1093/ajcp/aqab204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/05/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To elucidate pathologic markers of acute and chronic stress found but rarely reported in chronic child abuse. METHODS Autopsies of 3 cases of fatal child abuse with well-documented chronic maltreatment are reported, with an emphasis on the nontraumatic findings of acute and chronic stress. RESULTS Besides the overwhelming physical injuries, all 3 children and 1 additional case obtained for consultation had telogen effluvium, a form of alopecia well known to be associated with stress in adults and some children but never reported in chronic abuse. All 3 had the microscopic findings of markedly involuted thymus, a well-known marker of physiologic stress in children but only occasionally referred to in child abuse. All 3 also had microscopic findings of myocardial necrosis associated with supraphysiologic levels of catecholamine, a well-documented finding associated with stress but rarely reported in fatalities associated with child abuse. Two of the 3 children also had Anitschkow-like nuclear changes in cardiac tissue, markers associated with prior, nonischemic myocardial pathologies that may be associated with prior episodes of acute stress. CONCLUSIONS Pathologists are urged to explore these markers as supportive evidence in their own investigations of possible child abuse fatalities, especially when associated with stress.
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Affiliation(s)
| | - Ryan C Warner
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
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Colombino E, Biasato I, Vezzaro G, Amante E, Biagini D, Cavallarin L, Guerra N, Guil-Alcalà P, Mioletti S, Perona G, Tarantola M, Vincenti M, Guarda F, Mendéz-Sanchez A, Capucchio MT. Evaluation of stress-related parameters and intramural coronary arteriosclerosis in Lidia bulls and Piemontese oxen. ITALIAN JOURNAL OF ANIMAL SCIENCE 2021. [DOI: 10.1080/1828051x.2021.1993756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Elena Colombino
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Ilaria Biasato
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco (To), Italy
| | - Giorgia Vezzaro
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Eleonora Amante
- Centro Regionale antidoping e di Tossicologia "A. Bertinaria", Orbassano (To), Italy
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Davide Biagini
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco (To), Italy
| | - Laura Cavallarin
- Istituto di Scienze delle Produzioni Alimentari (CNR), Grugliasco (To), Italy
| | | | - Pilar Guil-Alcalà
- Departamento de Anatomía y Anatomía Patológica Comparadas, Universidad de Córdoba, Córdoba, Spain
| | - Silvia Mioletti
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Giovanni Perona
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Martina Tarantola
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Marco Vincenti
- Centro Regionale antidoping e di Tossicologia "A. Bertinaria", Orbassano (To), Italy
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Franco Guarda
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
| | - Aniceto Mendéz-Sanchez
- Departamento de Anatomía y Anatomía Patológica Comparadas, Universidad de Córdoba, Córdoba, Spain
| | - Maria Teresa Capucchio
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco (To), Italia
- Istituto di Scienze delle Produzioni Alimentari (CNR), Grugliasco (To), Italy
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Ryser-Degiorgis MP, Robert N, Meier RK, Zürcher-Giovannini S, Pewsner M, Ryser A, Breitenmoser U, Kovacevic A, Origgi FC. Cardiomyopathy Associated With Coronary Arteriosclerosis in Free-Ranging Eurasian Lynx ( Lynx lynx carpathicus). Front Vet Sci 2020; 7:594952. [PMID: 33409296 PMCID: PMC7779598 DOI: 10.3389/fvets.2020.594952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/26/2020] [Indexed: 11/30/2022] Open
Abstract
The Eurasian lynx (subspecies Lynx lynx carpathicus) was reintroduced to Switzerland in the 1970's. Health monitoring of the reintroduced population started in the late 1980's. Since then, six lynx have been found affected by a myocardial disease. The earliest case was an animal that died after a field anesthesia. Two lynx were found dead, two were euthanized/culled because of disease signs, and one was hit by car. Two had a heart murmur at clinical examination. At necropsy, the first animal showed only lung edema but the other five had cardiomegaly associated with myocardial fibrosis. Three had multisystemic effusions. Histological examination of all six lynx showed mild to severe, multifocal, myocardial interstitial and perivascular fibrosis along with multifocal myocyte degeneration and loss, and replacement fibrosis. Moderate to severe multifocal arteriosclerosis with associated luminal stenosis of the small and medium-sized intramural coronary arteries and the presence of Anitschkow cells was also observed. The heart lesions may have led to sudden death in the first case and to a chronic right-sided heart failure in the remaining. None of the lynx showed lesions or signs suggestive of an acute or subacute infection. Given the common geographic origin of these animals and the severe loss of heterozygocity in this population, a genetic origin of the disease is hypothesized.
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Affiliation(s)
| | - Nadia Robert
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Roman Kaspar Meier
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | - Mirjam Pewsner
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | | | - Alan Kovacevic
- Small Animal Clinic, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Francesco C Origgi
- Centre for Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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