Journal List > Korean J Leg Med > v.37(3) > 1004709

Korean J Leg Med. 2013 Aug;37(3):167-170. Korean.
Published online August 29, 2013.  https://doi.org/10.7580/kjlm.2013.37.3.167
© Copyright 2013 by the Korean Society for Legal Medicine
Sudden Death associated with Thyrotoxicosis: Report of Three Autopsy Cases
Ju-yeon Kim,1 Min-jung Kim,2 Sohyung Park,3 and Hongil Ha4
1Department of Pathology, Pusan National University Hospital, Busan, Korea.
2Division of Forensic Medicine, National Forensic Service, Seoul, Korea.
3Division of Forensic Medicine, Eastern District Office, National Forensic Service, Wonju-si, Gangwon, Korea.
4Division of Forensic Medicine, Southern District Office, National Forensic Service, Yangsan-si, Gyeongsangnam, Korea.

Corresponding author (Email: sanchee@korea.kr )
Received July 28, 2013; Revised August 14, 2013; Accepted August 23, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Thyrotoxicosis (thyroid crisis) is a known cause of sudden death; however, only a few cases of death resulting from thyrotoxicosis have been reported. Histopathologic examination and postmortem thyroid function tests may be helpful in postmortem diagnosis, but their usefulness seems to be limited. We report three autopsy cases associated with thyrotoxicosis.

Keywords: Thyrotoxicosis; Sudden death; Thyroid crisis; Autopsy

Figures


Fig. 1
(Case 1) The thyroid gland shows relatively symmetric enlargement with soft and meaty parenchyma (a). There are follicles of varying size, lined by tall columnar cells with decrease in the amount of colloid and formation of pseudopapillary structures (b: H & E, × 200).
Click for larger image


Fig. 2
(Case 2) There are diffuse hyperplasia of follicular epithelial cells in thyroid gland (H & E, × 200).
Click for larger image


Fig. 3
(Case 3) The cut surface shows nodules of varying size and a glistening parenchyma. Focal calcifications are seen (a). There are small follicles with scanty colloid lined by low cuboidal cells (b: H & E, × 200).
Click for larger image

References
1. James JL, Weetman AP. Disorders of the thyroid gland. In: Longo DL, Fauci AS, Kasper DL, et al., editors. Harrison's principles of internal medicine. 18th ed. New York: McGraw-Hill; 2011. pp. 2911-2939.
2. Franklyn JA, Boelaert K. Thyrotoxicosis. Lancet 2012;379:1155–1166.
3. Salvatore D, Davies TF, Schilumberger M, et al. Thyrotoxicosis. In: Melmed S, Polonsky KS, Larsen PR, et al., editors. Williams textbook of endocrinology. 11th ed. Philadelphia: Elsevier Sauders; 2011. pp. 362-405.
4. Nakatani Y, Monden T, Sato M, et al. Severe hypoglycemia accompanied with thyroid crisis. Case Rep Endocrinol. 2012 Nov 04;
5. Edston E, Druid H, Holmgren P, et al. Postmortem measurements of thyroid hormones in blood and vitreous humor combined with histology. Am J Forensic Med Pathol 2001;22:78–83.
6. Osman F, Franklyn JA, Holder RL, et al. Cardiovascular manifestations of hyperthyroidism before and after antithyroid therapy: a matched case-control study. J Am Coll Cardiol 2007;49:71–81.
7. Eberhart CG, Wiestler OD, Eng C. Cowden disease and dysplastic gangliocytoma of the cerebellum/Lhermitte-Duclos disease. In: Louis DN, Ohgaki H, Wiestler OD, et al., editors. WHO Classification of Tumours of the Central Nervous System. Lyon: IARC Press; 2007. pp. 226-228.
8. Kwon TJ, Kim TS, Lee HY, et al. Lhermitte-Duclos disease in a sudden death: an autopsy case. Korean J Pathol 1994;28:73–78.