Response to Byard's letter "traumatic asphyxia in the young".

Abstract

Byard’s report concerning Bpathological changes in the thyroid gland in crush asphyxia^ [1] presents four case reports with macroscopic as well as microscopic changes in the thyroid gland after death due to crush asphyxia. In all cases, he described black thyroid glands which most often have been associated with the use of the antibiotic minocycline [2, 3]. Histologically, the texture showed scattered blood lakes or islands within the colloid of the thyroid gland where vessels had been ruptured. He discussed that these blood lakes could Barise from leakage of intensely congested stromal capillaries, with rupture into adjacent follicles.^ Although he mentioned that these pathological changes are not pathognomonic for crush asphyxia and would be Bmerely manifestations,^ he proposed to look after this feature in similar cases. At Byard’s suggestion, we studied the autopsy report concerning our presented case. The thyroid gland was described as a brown-red gland with normal size and regular position. Black areas within the thyroid gland or a dark color of the whole gland were not mentioned. Unfortunately, we could not investigate the histological preparation anymore. Our case report refers to an accident which occurredmore than 10 years ago; the exhibits have been depolluted last year. Referring to the macroscopic description, the case showed no indication of the microscopic feature of blood islands in the colloid of a thyroid gland reported by Byard.