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Young person's death in bathtub: The cause of unexpected death in thyroid crisis



Young person's death in bathtub: The cause of unexpected death in thyroid crisis



Research and Practice in Forensic Medicine 41(0): 171-176



A 16-year-old, slightly lean female was found dead in a bathtub with hot water. An autopsy was performed 18 hours after death. At autopsy, abundant frothy fluid was observed in her airways, and we determined that she died from drowning. The enlarged thyroid gland (42.7 g) showed diffuse goiter. The level of total T4, TSH, and Anti TSH receptor antibody were 21.4 mug/ml (elevated), under 0.05 mug/ml (low), and 63.7% (elevated), respectively. We diagnosed that she had been in a state of hyperthyroidism and thyrotoxicosis. The heart weighed 215 g and myocardial hypertrophy was not observed. Microscopically, heart failure cells were not observed in the lung, and there was no possibility that the drowning was caused by heart failure. We assumed that both the untreated thyrotoxicosis and other inducements such as overwork and taking bath gave her sudden thyroid crisis.

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