PURPOSE: Multiple viruses have been detected in cardiac tissue, but their role in causing myocarditis remains controversial. Viral diagnostics are increasingly used in forensic medicine, but the interpretation of the results can sometimes be challenging. In this study, we examined the prevalence of adenovirus, enterovirus, and parvovirus B19 (PVB) in myocardial autopsy samples from myocarditis related deaths and in non-inflamed control hearts in an effort to clarify their significance as the causes of myocarditis in a forensic material. METHODS: We collected all autopsy cases diagnosed with myocarditis from 1992 to 2010. Eighty-four suicidal deaths with morphologically normal hearts served as controls. Polymerase chain reaction was used for the detection of the viral genomes (adenovirus, enterovirus, and PVB) in myocardial tissue specimens. The distinction between acute and persistent PVB infection was made by the serological determination of PVB-specific immunoglobulins M and G. RESULTS: PVB was detected in 33 of 112 (29 %) myocarditis cases and 37 of 84 (44 %) control cases. All of the samples were negative for the presence of adenovirus and enterovirus. Serological evidence of an acute PVB infection, determined by the presence of immunoglobulin M, was only present in one case. In the remaining cases, PVB was considered to be a bystander with no or limited association to myocardial inflammation. CONCLUSION: In this study, adenovirus, enterovirus, and PVB were found to be rare causes of myocarditis. The detection of PVB in myocardial autopsy samples most likely represents a persistent infection with no or limited association with myocardial inflammation. The forensic investigation of myocardial inflammation demands a thorough examination, including special attention to non-viral causes and requires a multidisciplinary approach.
PURPOSE: Multiple viruses have been detected in cardiac tissue, but their role in causing myocarditis remains controversial. Viral diagnostics are increasingly used in forensic medicine, but the interpretation of the results can sometimes be challenging. In this study, we examined the prevalence of adenovirus, enterovirus, and parvovirus B19 (PVB) in myocardial autopsy samples from myocarditis related deaths and in non-inflamed control hearts in an effort to clarify their significance as the causes of myocarditis in a forensic material. METHODS: We collected all autopsy cases diagnosed with myocarditis from 1992 to 2010. Eighty-four suicidal deaths with morphologically normal hearts served as controls. Polymerase chain reaction was used for the detection of the viral genomes (adenovirus, enterovirus, and PVB) in myocardial tissue specimens. The distinction between acute and persistent PVB infection was made by the serological determination of PVB-specific immunoglobulins M and G. RESULTS: PVB was detected in 33 of 112 (29 %) myocarditis cases and 37 of 84 (44 %) control cases. All of the samples were negative for the presence of adenovirus and enterovirus. Serological evidence of an acute PVB infection, determined by the presence of immunoglobulin M, was only present in one case. In the remaining cases, PVB was considered to be a bystander with no or limited association to myocardial inflammation. CONCLUSION: In this study, adenovirus, enterovirus, and PVB were found to be rare causes of myocarditis. The detection of PVB in myocardial autopsy samples most likely represents a persistent infection with no or limited association with myocardial inflammation. The forensic investigation of myocardial inflammation demands a thorough examination, including special attention to non-viral causes and requires a multidisciplinary approach.
Authors: Jeannette Guarner; Julu Bhatnagar; Wun-Ju Shieh; Kurt B Nolte; Dennis Klein; Michelle S Gookin; Silvia Peñaranda; M Steven Oberste; Tara Jones; Chalanda Smith; Mark A Pallansch; Sherif R Zaki Journal: Hum Pathol Date: 2007-06-28 Impact factor: 3.466
Authors: Yaiza Altuzarra-Ranedo; Daniel Gómez-Ramírez; María Rodríguez-Laguna; Pía Mercedes Lois-Bermejo; Blanca López-Pelaez; Noel Lorenzo-Villalba; Manuel Méndez-Bailon Journal: Eur J Case Rep Intern Med Date: 2022-01-28
Authors: Cristina Basso; Beatriz Aguilera; Jytte Banner; Stephan Cohle; Giulia d'Amati; Rosa Henriques de Gouveia; Cira di Gioia; Aurelie Fabre; Patrick J Gallagher; Ornella Leone; Joaquin Lucena; Lubov Mitrofanova; Pilar Molina; Sarah Parsons; Stefania Rizzo; Mary N Sheppard; Maria Paz Suárez Mier; S Kim Suvarna; Gaetano Thiene; Allard van der Wal; Aryan Vink; Katarzyna Michaud Journal: Virchows Arch Date: 2017-09-09 Impact factor: 4.064
Authors: Karim Hassan; Charles Kyriakakis; Anton Doubell; Gert Van Zyl; Mathilda Claassen; Dan Zaharie; Philip Herbst Journal: Open Heart Date: 2022-01