Post-mortem diagnosis of food anaphylaxis: a systematic review

Abstract

Food anaphylaxis is a type of severe and potentially fatal allergic reaction. Its classical immunological mechanism is IgE-dependent, with the involvement of mast cells and basophils. The occurrence of anaphylactic reaction requires prior sensitization and subsequent contact with the allergen, triggering the degranulation of the involved cells. The secreted granular content is responsible for the clinical manifestations presented by victims affected by this pathological event. Deaths caused by food anaphylaxis are difficult to diagnose by forensic pathologists due to various factors, such as the lack of specific pathological manifestations that allow for identification. In this systematic review, the aim is to highlight the main methods used in Forensic Sciences for the post-mortem diagnosis of food anaphylaxis. To do so, searches were conducted on Google Scholar between November 2023 and January 2024. Time filters were applied, delimiting the publication period between 2018 and 2023. The inclusion criteria used were: being published in English and addressing post-mortem diagnosis of anaphylaxis and/or food anaphylaxis. Exclusion criteria were: not mentioning the type of allergen causing the anaphylactic reaction or detailing only one test for diagnosis. All articles were read separately, analyzing the risk of bias. In total, 9 articles were selected for the review. The main techniques performed in the studies comprised an integrated approach of anamnestic and circumstantial data associated with autopsy and laboratory tests. Further studies are needed regarding the diagnostic flow in cases of anaphylactic deaths caused by food ingestion.

Keywords

Food Anaphylaxis
Post-mortem Diagnosis
Forensic Pathology
Anafilaxia Alimentar
Diagnóstico Post Mortem
Patologia Forense

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