Immunohistochemical marker for Na+ CP type Valpha (C-20) and heterozygous nonsense SCN5A mutation W822X in a sudden cardiac death induced by mild anaphylactic reaction

Appl Immunohistochem Mol Morphol. 2009 Jul;17(4):357-62. doi: 10.1097/PAI.0b013e3181955b37.

Abstract

A sudden death likely due to mild anaphylactic reaction in a young man is described. Autoptic, histologic, immunohistochemical, and laboratory findings were strongly consistent with the diagnosis of a mild anaphylactic reaction. Genetic molecular analysis, performed on formalin-fixed, paraffin-embedded tissues, showed a mutation described as W822X in a family with electrocardiographic pattern typical of Brugada Syndrome. It results in a nonsense mutation generating a truncated form of the channel protein. The mutation is due to a point substitution of a guanine with an adenine residue (G2466A). Immunohistochemistry and laser scanning confocal microscopy on sections from heart formalin-fixed, paraffin-embedded tissues led us to confirm the cellular localization of the Na+ CP type Valpha (C-20) at the intercalated disks of ventricular myocytes and nearly 50% reduction in Na+ channels expression in ventricular myocytes when compared with control cases. We suggest that the anaphylactic reaction that occurred in the young man could serve as a trigger mechanism, responsible for his sudden death with a SCN5A mutation associated with the Brugada syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaphylaxis / complications
  • Anaphylaxis / genetics*
  • Anaphylaxis / metabolism
  • Anaphylaxis / pathology
  • Brugada Syndrome / complications
  • Brugada Syndrome / genetics*
  • Brugada Syndrome / metabolism
  • Brugada Syndrome / pathology
  • Death, Sudden, Cardiac* / etiology
  • Fatal Outcome
  • Humans
  • Male
  • Muscle Proteins / genetics*
  • Muscle Proteins / metabolism
  • Mutation, Missense*
  • Myocardium / metabolism
  • Myocardium / pathology
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / pathology
  • NAV1.5 Voltage-Gated Sodium Channel
  • Peanut Hypersensitivity / complications
  • Peanut Hypersensitivity / genetics*
  • Peanut Hypersensitivity / metabolism
  • Peanut Hypersensitivity / pathology
  • Sodium Channels / genetics*
  • Sodium Channels / metabolism

Substances

  • Muscle Proteins
  • NAV1.5 Voltage-Gated Sodium Channel
  • SCN5A protein, human
  • Sodium Channels