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AJSP2206 - CME/CMLE - Morphologic Markers of Acute ...
Morphologic Markers of Acute and Chronic Stress in ...
Morphologic Markers of Acute and Chronic Stress in Child Abuse
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Pdf Summary
The article discusses morphologic markers of acute and chronic stress in cases of fatal chronic child abuse. Three cases of fatal child abuse are detailed, emphasizing nontraumatic findings related to stress. Findings include telogen effluvium, thymic involution, and myocardial necrosis associated with supraphysiologic catecholamine levels. The presence of Anitschkow-like nuclear changes in cardiac tissue is also highlighted. These markers, rarely reported in cases of child abuse, serve as evidence of chronic stress and may help pathologists identify and categorize abuse cases. Besides visible physical injuries, these markers provide insights into the stress children endure, aiding in understanding the context of abuse fatalities. Awareness of these findings, such as telogen effluvium from hormonal disturbances, thymic involution from corticosteroids, and myocardial changes from catecholamine toxicity, can assist in recognizing and documenting abuse-related stress. The study urges practitioners in child welfare to consider these markers during investigations of child abuse cases to help prevent further fatalities. The presented cases shed light on the importance of recognizing these morphologic markers to better understand and address child abuse issues effectively.
Keywords
acute stress
chronic stress
fatal child abuse
telogen effluvium
thymic involution
myocardial necrosis
catecholamine levels
Anitschkow-like nuclear changes
hormonal disturbances
corticosteroids
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