RESUMO
BACKGROUND: An allergic reaction with increased degranulation of mast cells has been suggested as a possible mechanism in sudden infant death syndrome (SIDS). STUDY DESIGN: Mast cell releasability was assessed in 2 study groups: A, 22 subjects, 16 first-degree relatives of infants who had had an apparent life-threatening event (ALTE) and 6 infants after ALTE and B, 46 first-degree relatives of SIDS cases. These groups were compared with 71 members of an age-matched control group. In each subject the skin wheal and flare reactions were measured after an intradermal injection of 0.02 mL of each of the following substances dissolved in phenol-saline solution: histamine 0.0001 mg/mL, histamine 0.001 mg/mL, codeine 0.5 mg/mL, codeine 1 mg/mL, compound 48/80 0.05 mg/mL, compound 48/80 0. 1 mg/mL, and phenol-saline solution. The size of wheal and flare skin reaction was assessed by computerized planimetry after the shape of the cutaneous response was copied onto a paper. RESULTS: The wheal and flare skin reaction to each of the substances was significantly larger in the 2 study groups compared with the control group (P <.05) except for the wheal reaction to compound 48/80 0.1 mg/mL, codeine 0.5 mg/mL, and histamine in both concentrations for group A and the wheal reaction to codeine 1 mg/mL and histamine in both concentrations for group B. All individuals with increased reaction belonged to 3 (50%) of 6 families with ALTE history and to 8 (73%) of 11 families with SIDS history. CONCLUSIONS: Increased mast cell hyper-releasability and degranulation take place in family members of some SIDS and ALTE cases and in some infants with ALTE, supporting a possible role for an immunologic mechanism in the pathophysiology of these entities.
Assuntos
Apneia/imunologia , Mastócitos/imunologia , Morte Súbita do Lactente/imunologia , Adulto , Apneia/etiologia , Apneia/genética , Degranulação Celular/imunologia , Criança , Feminino , Humanos , Imunidade Celular , Lactente , Masculino , Mastócitos/fisiologia , Testes Cutâneos/métodos , Testes Cutâneos/estatística & dados numéricos , Estatísticas não Paramétricas , Morte Súbita do Lactente/etiologia , Morte Súbita do Lactente/genéticaRESUMO
El síndrome de muerte súbita es uno de los enigmas médicos aún no resueltos. Las importantes contribuciones realizadas por epidemiólogos y patólogos en el entendimiento de este síndrome han permitido implementar medidas eficaces en su prevención. En el presente artículo se revisarán aspectos de la fisiología del patrón respiratorio, definiciones, factores de riesgo y etiopatogenia del síndrome de muerte súbita