Diagnóstico post mortem de anafilaxia alimentar: uma revisão sistemática

Gleisse Licene  Neves; Glenda Liege Neves; Ariadne de Andrade Costa

doi:10.15260/rbc.v13i3.825

Diagnóstico post mortem de anafilaxia alimentar: uma revisão sistemática

Vol. 13 Núm. 3 (2024)
81-87
14/03/2024
10/10/2024
10.15260/rbc.v13i3.825

Resumen

A anafilaxia alimentar é um tipo de reação alérgica grave e potencialmente fatal. Seu mecanismo imunológico clássico é dependente de IgE, com participação de mastócitos e basófilos. A ocorrência da reação anafilática requer sensibilização prévia e contato subsequente com o alérgeno, ativando a desgranulação das células envolvidas. O conteúdo granular secretado é responsável pelas manifestações clínicas apresentadas pelas vítimas acometidas por esse evento patológico. As mortes causadas por anafilaxia alimentar são difíceis de serem diagnosticadas pelos patologistas forenses devido a muitos fatores, como a falta de manifestações patológicas específicas que permitam sua identificação. Nesta revisão sistemática, tem-se como objetivo destacar os principais métodos usados nas Ciências Forenses para o diagnóstico post mortem de anafilaxia alimentar. Para tanto, realizou-se buscas no Google Acadêmico entre novembro de 2023 e janeiro de 2024. Foram aplicados filtros de tempo, delimitando-se o período de publicação entre 2018 e 2023. Os critérios de inclusão usados foram: ser publicado em inglês e abordar o diagnóstico post mortem de anafilaxia e/ou anafilaxia alimentar. Já os de exclusão foram: não mencionar o tipo de alérgeno causador da reação anafilática ou detalhar apenas um teste para diagnóstico. Todos os artigos foram lidos separadamente, analisando-se o risco de viés. Ao todo, foram selecionados 9 artigos para compor a revisão. As principais técnicas realizadas nos estudos compreendiam uma abordagem integrada de dados anamnésicos e circunstanciais associados à necropsia e a exames laboratoriais. Mais estudos são necessários acerca do fluxo de diagnóstico em casos de mortes anafiláticas provocadas pela ingestão de alimentos.

Citas

L.L. Reber; J.D. Hernandez; S.J. Galli. The pathophysiology of anaphylaxis. J. Allergy Clin. Immunol. 140: 335-348 (2017).
H.C.H. Broekman; T. Eiwegger; J. Upton; K.L. Bøgh. IgE - the main player of food allergy. Drug Discov. Today Dis. Models 17: 37-44 (2015).
A.C. Pastorino; M.C.F.V. Rizzo; N.P.M Rubini; G.W.S. Di Gesu; G.M.S. Di Gesu; N.A.R. Filho; J.N. Tebyriça; D. Solé; L.A.G. Bernd; M.A.C. Spindola; R.S. Simões. Anaphylaxis: diagnostic. Rev. Assoc. Med. Bras. 59: 7-13 (2013).
S.F. Kemp; R.F. Lockey. Anaphylaxis: A review of causes and mechanisms. J. Allergy Clin. Immunol. 110: 341-348 (2002).
A. González-Pérez; Z. Aponte; C.F. Vidaurre; L.A.G. Rodríguez. Anaphylaxis epidemiology in patients with and patients without asthma: A United Kingdom database review. J. Allergy Clin. Immunol. 125: 1098-1104 (2010).
R.A Wood; C.A. Camargo; P. Lieberman; H.A. Sampson; L.B. Schwartz; M. Zitt; C. Collins; M. Tringale; M. Wilkinson; J. Boyle; F.E.R. Simons. Anaphylaxis in America: The prevalence and characteristics of anaphylaxis in the United States. J. Allergy Clin. Immunol. 133: 461-467 (2014).
T. Umasunthar; J. Leonardi-Bee; M. Hodes; P.J. Turner; C. Gore; P. Habibi; J.O. Warner; R.J. Boyle. Incidence of fatal food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin. Exp. Allergy 43: 1333-1341 (2013).
K. Brockow; J. Ring. Food Anaphylaxis. Anal. Bioanal. Chem. 395: 17-23 (2009).
I. Mercurio; F. Cornacchia; D. Capano; L. Ricci; D. Piergiovanni; M. Gabbrielli. Serum tryptase, Immunoglobuline E assay and circumstantial data are fundamental tools for the post-mortem diagnosis of food anaphylaxis: a case report and literature review. Rom. J. Leg. Med. 26: 47-50 (2018).
J.W. Youginger; D.R. Nelson; D.L. Squillace; R.T. Jones; K.E. Holley; B.A. Hyma; L. Biedrzycki; K.G. Sweeney; W.Q. Sturner; L.B. Schwartz. Laboratory investigation of deaths due to anaphylaxis. J. Forensic Sci. 36: 857-865 (1991).
E. Edston; M. Van Hage-Hamsten. Mast cell tryptase and hemolysis after trauma. Forensic Sci. Int. 131: 8-13 (2003).
C. Palmiere; L. Comment; R. Vilarino; P. Mangin; L.R. Bonetti. Measurement of β-tryptase in postmortem serum in cardiac deaths. J. Forensic Leg. Med. 23: 12-18 (2014).
L.B. Schwartz; A.A. Irani. Serum tryptase and the laboratory diagnosis of systemic mastocytosis. Hematol. Oncol. Clin. North Am. 14: 641-657 (2000).
M.J. Page; J.E. McKenzie; P.M. Bossuyt; I. Boutron; T.C. Hoffmann; C.D. Mulrow; L. Shamseer; J.M. Tetzlaf; E.A. Akl; S.E. Brennan; R. Chou; J. Glanville; J.M. Grimshaw; A. Hróbjartsson; M.M. Lalu; T. Li; E.W. Loder; E. Mayo-Wilson; S. McDonald; L.A. McGuinness; L.A. Stewart; J. Thomas; A.C. Tricco; V.A. Welch; P. Whiting; D. Moher. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int. J. Surg. 88: 105906 (2021).
E. Nuñez-Borque; S. Fernandez-Bravo; A. Yuste-Montalvo; V. Esteban. Pathophysiological, cellular, and molecular events of the vascular system in anaphylaxis. Frontiers in Immunology 13: 836222 (2022).
T. Waterfield; E. Dyer; K. Wilson; R. Boyle. How to interpret mast cell tests. Arch. Dis. Child Educ. Pract. Ed. 101: 246-251 (2016).
S.E. Turvey; D.H. Broide. Innate immunity. J. Allergy Clin. Immunol. 125: S24-S32 (2010).
D.E.A. Komi; S. Wöhrl; L. Bielory. Mast cell biology at molecular level: a comprehensive review. Clinic. Rev. Allerg. Immunol. 58: 342-365 (2020).
C. Cingi; N.B. Muluk. Quick Guide to Anaphylaxis, Springer, Turkey (2020) 163-164.
Y. Ogawa; J.A. Grant. Mediators of anaphylaxis. Immunol. Allergy Clin. N. Am. 27: 249-260 (2007).
V. Kumar; A.K. Abbas; J.C. Aster. Robbins and Cotran Pathologic Basis of Disease, 9th edition, Elsevier, United States of America (2016) 322-327.
M. Esposito; A. Montana; A. Liberto; V. Filetti; N.D. Nunno; F. Amico; M. Salerno; C. Loreto; F. Sessa. Anaphylactic death: a new forensic workflow for diagnosis. Healthcare 9: 117 (2021).
S. Tambuzzi; G. Gentile; M. Boracchi; D.D. Candia; R. Bianchi; R. Zoja. Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion. Forensic Sci. Med. Pathol. 17: 449-455 (2021).
N. Heldring; L. Kahn; B. Zilg. Fatal anaphylactic shock: A review of postmortem biomarkers and diagnostics. Forensic Sci. Int. 323: 110814 (2021).
S. Unkrig; L. Hagemeier; B. Madea. Postmortem diagnostics of assumed food anaphylaxis in an unexpected death. Forensic Sci. Int. 198: e1-e4 (2010).
S. D’Errico; A. Santurro; M. Scopetti; P. Frati; V. Fineschi. Fatal food-induced anaphylaxis: Determination of tryptase and specific IgE on cadaveric blood samples. What else for a better methodological standard?. Int. J. Immunopathol. Pharmacol. 34: 2058738420950579 (2020).
P. Martínez-Fernandez; G. Vallejo-de-Torres; M.S. Sánchez-de-León-Robles; E. Navarro-Escayola; M. Moro-Moro; N. Alberti-Masgrau; M.A. Tejedor-Alonso. Medical and pathologic characteristics of fatal anaphylaxis: a Spanish nationwide 17-year series. Forensic Sci. Med. Pathol. 15: 369-381 (2019).
V. Sterzik; V. Drendel; M. Will; M. Bohnert. Suicide of a man with known allergy to fish protein by ingesting tinned fish. Forensic Sci. Int. 221: e4-e6 (2012).
S. Burkhardt; P. Genet; S. Sabatasso; R.L. Harpe. Death by anaphylactic shock in an institution: an accident or negligence?. Int. J. Legal Med. 133: 561-564 (2019).
F. Colombo; P. Restani; C.D. Lorenzo; S. Biella; E. Turillazzi; M.D. Paolo. Sudden anaphylactic death: new insights to identify allergens involved. J. Clin. Pathol. 73: 777-780 (2020).
R. Cecchi. Diagnosis of anaphylactic death in forensics: Review and future perspectives. Leg. Med. 22: 75-81 (2016).
I. Low; S. Stables. Anaphylactic deaths in Auckland, New Zealand: a review of coronial autopsies from 1985 to 2005. Pathology 38: 328-332 (2006).
A. McLean-Tooke; M. Goulding; C. Bundell; J. White; P. Hollingsworth. Postmortem serum tryptase levels in anaphylactic and non-anaphylactic deaths. J. Clin. Pathol. 67: 134-138 (2014).
D.E. Mayer; A. Krauskopf; W. Hemmer; K. Moritz; R. Jarisch; C. Reiter. Usefulness of post mortem determination of serum tryptase, histamine and diamine oxidase in the diagnosis of fatal anaphylaxis. Forensic Sci. Int. 212: 96-101 (2011).
J. Garland; B. Ondruschka; U. Da Broi; C. Palmiere; C. Glenn; P. Morrow; K. Kesha; S. Stables; R. Tse. Differences between central and peripheral postmortem tryptase levels. Am. J. Forensic Med. Pathol. 42: 125-129 (2021).
M.A. Tejedor-Alonso; G. Vallejo-de-Torres; E.N. Escayola; P. Martínez-Fernandez; M. Moro-Moro; N.A. Masgrau. Postmortem tryptase cutoff points and main causes of fatal anaphylaxis. J. Allergy Clin. Immunol. Pract. 8: 761-763 (2020).
L. Tran; C. Palmiere. Postmortem serum levels of total IgE. Int. J. Legal Med. 130: 1567–1573 (2016).

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Derechos de autor 2024 Revista Brasileira de Criminalística

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Autor(es)

Gleisse Licene Neves,

Glenda Liege Neves,

Ariadne de Andrade Costa,

[1] L.L. Reber; J.D. Hernandez; S.J. Galli. The pathophysiology of anaphylaxis. J. Allergy Clin. Immunol. 140: 335-348 (2017).

[2] H.C.H. Broekman; T. Eiwegger; J. Upton; K.L. Bøgh. IgE - the main player of food allergy. Drug Discov. Today Dis. Models 17: 37-44 (2015).

[3] A.C. Pastorino; M.C.F.V. Rizzo; N.P.M Rubini; G.W.S. Di Gesu; G.M.S. Di Gesu; N.A.R. Filho; J.N. Tebyriça; D. Solé; L.A.G. Bernd; M.A.C. Spindola; R.S. Simões. Anaphylaxis: diagnostic. Rev. Assoc. Med. Bras. 59: 7-13 (2013).

[4] S.F. Kemp; R.F. Lockey. Anaphylaxis: A review of causes and mechanisms. J. Allergy Clin. Immunol. 110: 341-348 (2002).

[5] A. González-Pérez; Z. Aponte; C.F. Vidaurre; L.A.G. Rodríguez. Anaphylaxis epidemiology in patients with and patients without asthma: A United Kingdom database review. J. Allergy Clin. Immunol. 125: 1098-1104 (2010).

[6] R.A Wood; C.A. Camargo; P. Lieberman; H.A. Sampson; L.B. Schwartz; M. Zitt; C. Collins; M. Tringale; M. Wilkinson; J. Boyle; F.E.R. Simons. Anaphylaxis in America: The prevalence and characteristics of anaphylaxis in the United States. J. Allergy Clin. Immunol. 133: 461-467 (2014).

[7] T. Umasunthar; J. Leonardi-Bee; M. Hodes; P.J. Turner; C. Gore; P. Habibi; J.O. Warner; R.J. Boyle. Incidence of fatal food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin. Exp. Allergy 43: 1333-1341 (2013).

[8] K. Brockow; J. Ring. Food Anaphylaxis. Anal. Bioanal. Chem. 395: 17-23 (2009).

[9] I. Mercurio; F. Cornacchia; D. Capano; L. Ricci; D. Piergiovanni; M. Gabbrielli. Serum tryptase, Immunoglobuline E assay and circumstantial data are fundamental tools for the post-mortem diagnosis of food anaphylaxis: a case report and literature review. Rom. J. Leg. Med. 26: 47-50 (2018).

[10] J.W. Youginger; D.R. Nelson; D.L. Squillace; R.T. Jones; K.E. Holley; B.A. Hyma; L. Biedrzycki; K.G. Sweeney; W.Q. Sturner; L.B. Schwartz. Laboratory investigation of deaths due to anaphylaxis. J. Forensic Sci. 36: 857-865 (1991).

[11] E. Edston; M. Van Hage-Hamsten. Mast cell tryptase and hemolysis after trauma. Forensic Sci. Int. 131: 8-13 (2003).

[12] C. Palmiere; L. Comment; R. Vilarino; P. Mangin; L.R. Bonetti. Measurement of β-tryptase in postmortem serum in cardiac deaths. J. Forensic Leg. Med. 23: 12-18 (2014).

[13] L.B. Schwartz; A.A. Irani. Serum tryptase and the laboratory diagnosis of systemic mastocytosis. Hematol. Oncol. Clin. North Am. 14: 641-657 (2000).

[14] M.J. Page; J.E. McKenzie; P.M. Bossuyt; I. Boutron; T.C. Hoffmann; C.D. Mulrow; L. Shamseer; J.M. Tetzlaf; E.A. Akl; S.E. Brennan; R. Chou; J. Glanville; J.M. Grimshaw; A. Hróbjartsson; M.M. Lalu; T. Li; E.W. Loder; E. Mayo-Wilson; S. McDonald; L.A. McGuinness; L.A. Stewart; J. Thomas; A.C. Tricco; V.A. Welch; P. Whiting; D. Moher. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int. J. Surg. 88: 105906 (2021).

[15] E. Nuñez-Borque; S. Fernandez-Bravo; A. Yuste-Montalvo; V. Esteban. Pathophysiological, cellular, and molecular events of the vascular system in anaphylaxis. Frontiers in Immunology 13: 836222 (2022).

[16] T. Waterfield; E. Dyer; K. Wilson; R. Boyle. How to interpret mast cell tests. Arch. Dis. Child Educ. Pract. Ed. 101: 246-251 (2016).

[17] S.E. Turvey; D.H. Broide. Innate immunity. J. Allergy Clin. Immunol. 125: S24-S32 (2010).

[18] D.E.A. Komi; S. Wöhrl; L. Bielory. Mast cell biology at molecular level: a comprehensive review. Clinic. Rev. Allerg. Immunol. 58: 342-365 (2020).

[19] C. Cingi; N.B. Muluk. Quick Guide to Anaphylaxis, Springer, Turkey (2020) 163-164.

[20] Y. Ogawa; J.A. Grant. Mediators of anaphylaxis. Immunol. Allergy Clin. N. Am. 27: 249-260 (2007).

[21] V. Kumar; A.K. Abbas; J.C. Aster. Robbins and Cotran Pathologic Basis of Disease, 9th edition, Elsevier, United States of America (2016) 322-327.

[22] M. Esposito; A. Montana; A. Liberto; V. Filetti; N.D. Nunno; F. Amico; M. Salerno; C. Loreto; F. Sessa. Anaphylactic death: a new forensic workflow for diagnosis. Healthcare 9: 117 (2021).

[23] S. Tambuzzi; G. Gentile; M. Boracchi; D.D. Candia; R. Bianchi; R. Zoja. Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion. Forensic Sci. Med. Pathol. 17: 449-455 (2021).

[24] N. Heldring; L. Kahn; B. Zilg. Fatal anaphylactic shock: A review of postmortem biomarkers and diagnostics. Forensic Sci. Int. 323: 110814 (2021).

[25] S. Unkrig; L. Hagemeier; B. Madea. Postmortem diagnostics of assumed food anaphylaxis in an unexpected death. Forensic Sci. Int. 198: e1-e4 (2010).

[26] S. D’Errico; A. Santurro; M. Scopetti; P. Frati; V. Fineschi. Fatal food-induced anaphylaxis: Determination of tryptase and specific IgE on cadaveric blood samples. What else for a better methodological standard?. Int. J. Immunopathol. Pharmacol. 34: 2058738420950579 (2020).

[27] P. Martínez-Fernandez; G. Vallejo-de-Torres; M.S. Sánchez-de-León-Robles; E. Navarro-Escayola; M. Moro-Moro; N. Alberti-Masgrau; M.A. Tejedor-Alonso. Medical and pathologic characteristics of fatal anaphylaxis: a Spanish nationwide 17-year series. Forensic Sci. Med. Pathol. 15: 369-381 (2019).

[28] V. Sterzik; V. Drendel; M. Will; M. Bohnert. Suicide of a man with known allergy to fish protein by ingesting tinned fish. Forensic Sci. Int. 221: e4-e6 (2012).

[29] S. Burkhardt; P. Genet; S. Sabatasso; R.L. Harpe. Death by anaphylactic shock in an institution: an accident or negligence?. Int. J. Legal Med. 133: 561-564 (2019).

[30] F. Colombo; P. Restani; C.D. Lorenzo; S. Biella; E. Turillazzi; M.D. Paolo. Sudden anaphylactic death: new insights to identify allergens involved. J. Clin. Pathol. 73: 777-780 (2020).

[31] R. Cecchi. Diagnosis of anaphylactic death in forensics: Review and future perspectives. Leg. Med. 22: 75-81 (2016).

[32] I. Low; S. Stables. Anaphylactic deaths in Auckland, New Zealand: a review of coronial autopsies from 1985 to 2005. Pathology 38: 328-332 (2006).

[33] A. McLean-Tooke; M. Goulding; C. Bundell; J. White; P. Hollingsworth. Postmortem serum tryptase levels in anaphylactic and non-anaphylactic deaths. J. Clin. Pathol. 67: 134-138 (2014).

[34] D.E. Mayer; A. Krauskopf; W. Hemmer; K. Moritz; R. Jarisch; C. Reiter. Usefulness of post mortem determination of serum tryptase, histamine and diamine oxidase in the diagnosis of fatal anaphylaxis. Forensic Sci. Int. 212: 96-101 (2011).

[35] J. Garland; B. Ondruschka; U. Da Broi; C. Palmiere; C. Glenn; P. Morrow; K. Kesha; S. Stables; R. Tse. Differences between central and peripheral postmortem tryptase levels. Am. J. Forensic Med. Pathol. 42: 125-129 (2021).

[36] M.A. Tejedor-Alonso; G. Vallejo-de-Torres; E.N. Escayola; P. Martínez-Fernandez; M. Moro-Moro; N.A. Masgrau. Postmortem tryptase cutoff points and main causes of fatal anaphylaxis. J. Allergy Clin. Immunol. Pract. 8: 761-763 (2020).

[37] L. Tran; C. Palmiere. Postmortem serum levels of total IgE. Int. J. Legal Med. 130: 1567–1573 (2016).