Myocarditis als oorzaak van plotseling, onverwacht overlijden in de eerste twee levensjaren

Objective. Estimate the prevalence of myocarditis as a cause of death in a group of suddenly deceased children (<2 years), as registered by the Cot Death Committee (CDC) of the Dutch Pediatric Association (1.9.1996-31.8.2006). Study its significance, its prevalence and the optimal investigation to establish the diagnosis of myocarditis. Design. Retrospective descriptive study. Method. Data were reviewed from all sudden death children reported to the CDC and estimated were the number of times that complete post mortem investigation led to the diagnosis of myocarditis. Signs and symptoms before death and pediatric and pathologic postmortal investigations were evaluated. Results and conclusions. Four of 200 infants under 2 years who died suddenly and unexpected during the study period had clear signs of myocarditis. This probably reflects an underestimation of the total number of infants of less than 2 years dying from myocarditis. We provide recommendations to increase the likelihood of demonstrating myocarditis as the cause of death in infants dying from SIDS: general virological investigation, histopathological and immunohistochemical investigation on multiple tissue samples, and specific virological investigation on cardiac samples, to be taken during post-mortem investigation.