Long QT syndrome KCNH2 mutation with sequential fetal and maternal sudden death

Forensic Sci Med Pathol. 2018 Sep;14(3):367-371. doi: 10.1007/s12024-018-9989-3. Epub 2018 Jun 8.

Abstract

We report a case of a woman who experienced intrauterine fetal death at full term pregnancy, and then died suddenly soon after learning about the death of her fetus. At autopsy, previously undiagnosed neurofibromatosis and an adrenal gland pheochromocytoma were discovered in the mother. Genetic screening also revealed a novel KCNH2mutation in both fetus and mother indicating type 2 congenital long-QT syndrome (LQTS). A catecholamine surge was suspected as the precipitating event of fetal cardiac arrhythmia and sudden fetal death, while the addition of emotional stress provoked a lethal cardiac event in the mother. This case illustrates the potential for lethal interactions between two occult diseases (pheochromocytoma, LQTS).

Keywords: Long QT syndrome; Neurofibromatosis; Pheochromocytoma; Sudden intrauterine death; Sudden maternal death in pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / pathology
  • Adult
  • Death, Sudden, Cardiac
  • ERG1 Potassium Channel / genetics*
  • Female
  • Fetal Death*
  • Heart Arrest / etiology
  • Humans
  • Long QT Syndrome / genetics*
  • Mutation*
  • Neurofibromatoses / diagnosis
  • Pheochromocytoma / pathology
  • Pregnancy

Substances

  • ERG1 Potassium Channel
  • KCNH2 protein, human