Unexpected death of a patient with rheumatoid arthritis complicated by a cervical deformity

Legal Medicine
Kana UnumaKen-ichi Yoshida

Abstract

An elderly female with a 43-year history of rheumatoid arthritis died 2weeks after the onset of chest discomfort, electrolyte disturbance, and interstitial pneumonia. She had frequent premature ventricular contractions, fluctuating heart rate, and hypotension. Ischemic heart disease and interstitial pneumonia were excluded as the cause of death based on clinical course and autopsy findings. A severe cervical deformity with myelopathy likely contributed to circulatory instability, possibly through injury to the intra-spinal sympathetic nervous system, which can induce cardiovascular instability and suppress respiratory function. This likely led to death.

References

Mar 6, 2003·Cardiovascular Research·Mariah L Walker, David S Rosenbaum
Jul 23, 1955·British Medical Journal·A ARONOFFG R FEARNLEY
Sep 20, 2005·Herz·Margret KungChristiane E Angermann
Sep 19, 2006·Rheumatology·P M SeferovićM Matucci-Cerinic
Aug 19, 2007·International Journal of Legal Medicine·Saskia S GuddatRoger W Byard
Sep 20, 2007·The Journal of Medical Investigation : JMI·Kiyoshi HashimotoEiji Shimizu
Jun 25, 1949·Journal of the American Medical Association·O STEINBROCKERR C BATTERMAN

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