Confirming anaphylaxis postmortem using serodiagnostic tests

Abstract

The difficulty of diagnosing anaphylaxis postmortem has remained a challenge during an autopsy investigation. The main challenges as summarised by Da Broi and Moreschi are:

Most cases occur outside the medical environment and are seldom witnessed, which means a lack of vital supportive information or medical history.

The lack or absence of internal and external signs (macroscopic and microscopic) of anaphylaxis at autopsy.

Biological fluids may be unavailable and chemical composition of analytes may be modified due to cytolytic or thanatological processes.

Biomarkers indicative of anaphylaxis are marred by a myriad of complications and remain mostly unreliable in forensic medicine.

Forensic experience, or the lack thereof, especially concerning the immunopathology of anaphylaxis also can curtail the diagnosis.