%0 Journal Article
%T Morphologic markers of acute and chronic stress in child abuse
%J American journal of clinical pathology
%D 2021
%A Flomenbaum, Mark A.
%A Warner, Ryan C.
%V ePub
%N ePub
%P ePub-ePub
%X OBJECTIVES: To elucidate pathologic markers of acute and chronic stress found but rarely reported in chronic child abuse. <br><br>METHODS: Autopsies of 3 cases of fatal child abuse with well-documented chronic maltreatment are reported, with an emphasis on the nontraumatic findings of acute and chronic stress. <br><br>RESULTS: Besides the overwhelming physical injuries, all 3 children and 1 additional case obtained for consultation had telogen effluvium, a form of alopecia well known to be associated with stress in adults and some children but never reported in chronic abuse. All 3 had the microscopic findings of markedly involuted thymus, a well-known marker of physiologic stress in children but only occasionally referred to in child abuse. All 3 also had microscopic findings of myocardial necrosis associated with supraphysiologic levels of catecholamine, a well-documented finding associated with stress but rarely reported in fatalities associated with child abuse. Two of the 3 children also had Anitschkow-like nuclear changes in cardiac tissue, markers associated with prior, nonischemic myocardial pathologies that may be associated with prior episodes of acute stress. <br><br>CONCLUSIONS: Pathologists are urged to explore these markers as supportive evidence in their own investigations of possible child abuse fatalities, especially when associated with stress.<p /> <p>Language: en</p>
%G en
%I American Society of Clinical Pathologists
%@ 0002-9173
%U http://dx.doi.org/10.1093/ajcp/aqab204