Journal List > Korean J Leg Med > v.42(4) > 1108847

Kim and Park: An Experience of Judicial Autopsy for a Death by Muscular Dystrophy: An Autopsy Case

Abstract

Progressive muscular dystrophy (PMD) is a primary muscle disease characterized by progressive muscle weakness and wasting, which is inherited by an X-linked recessive pattern and occurs mainly in males. There are several types of muscular dystrophies classified according to the distribution of predominant muscle weakness including Duchenne and Becker, Emery-Dreifuss, facioscapulohumeral, oculopharyngeal, and limb-girdle type. Clinical manifestations of PMD are clumsy, unsteady gait, pneumonia, heart failure, pulmonary edema, hydropericardium, hydrothorax, aspiration, syncopal attacks, and sudden cardiac death. The deceased was a 34-year-old man, and the onset of the first clinical symptom, gait disturbance, was in his late teens. His elder brother had the same disease and experienced brain death after a head trauma and died after mechanical ventilation was discontinued. After an autopsy, we found contracture of the joints, pseudohypertrophy of the calf, wasting and fat replacement of the thigh muscle, pericardial effusion (80 mL), fibrosis and fat replacement of the cardiac ventricular wall, pulmonary edema, and froth in the bronchus. The cause of death was heart failure and dyspnea due to muscular dystrophy. There was no sign or suspicion of foul play in his death.

Figures and Tables

Fig. 1

A photograph showing pseudohypertrophy of the calf area.

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Fig. 2

Dissection of the thigh shows yellow discoloration of the muscle.

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Fig. 3

Histology of the muscle shows replacement of muscle fiber by fat tissue (H&E stain, ×50).

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Fig. 4

On the cut section of the heart, fibrotic foci are noted on the ventricle wall.

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Fig. 5

Microscopic examination of the heart wall reveals fibrosis of the muscle and replacement by fat tissue (H&E stain, ×50).

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Notes

Conflicts of Interest No potential conflicts of interest relevant to this article was reported.

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ORCID iDs

Youn Shin Kim
https://orcid.org/0000-0001-7407-0421

Ji Hye Park
https://orcid.org/0000-0002-9467-2232

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