J Korean Med Sci.  2018 Aug;33(32):e200. 10.3346/jkms.2018.33.e200.

Retrospective Genetic Analysis of 200 Cases of Sudden Infant Death Syndrome and Its Relationship with Long QT Syndrome in Korea

Affiliations
  • 1Department of Forensic Medicine and Institute of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea. yoosh@snu.ac.kr
  • 2Division of Forensic Medicine, National Forensic Service, Seoul, Korea.
  • 3Medical Examiner's Office, National Forensic Service, Wonju, Korea.

Abstract

BACKGROUND
There has been a campaign by the National Education on Sleeping Habits and Living Environment, to reduce the incidence of sudden infant death syndrome (SIDS). However, more than 100 infants die suddenly and unexplainably before the age of 1 year in Korea. Long QT syndrome (LQTS), an inheritable cardiac disease, has been reported to likely be associated with up to 14% of SIDS cases. However, genetic studies of the association between SIDS and LQTS have not yet been conducted in Korea.
METHODS
We conducted genetic analysis using genomic DNA extracted from paraffin-embedded tissue blocks from 200 SIDS cases autopsied between 2005 and 2013. We analyzed the following genetic mutations associated with LQTS, KCNQ1, SCN5A, KCNE1, KCNE2, KCNJ2, and CAV3.
RESULTS
Of the 200 SIDS cases, 58% involved male infants (116 male and 84 female infants, respectively), the mean age was 140 days (median, 107 days; range, 24-270 days), and they were all of Asian-Korean ethnicity. SIDS IA category criteria comprised 45 cases (22.5%) while the rest were SIDS IB. Fifteen infants (7.5%) had R1193Q in SCN5A, of doubtful pathogenicity, and no pathogenic LQTS variants were observed.
CONCLUSION
This genetic investigation of LQTS in SIDS showed a low diagnostic yield. These findings suggest that LQTS molecular autopsy could be cautiously conducted in selected cases with family involvement to improve the available genetic counseling information. Meanwhile, a national SIDS registry should be established to document and evaluate the genetic risk of SIDS in Korea.

Keyword

Sudden Infant Death Syndrome; Long QT Syndrome; Molecular Autopsy; Genetic

MeSH Terms

Autopsy
DNA
Education
Female
Genetic Counseling
Heart Diseases
Humans
Incidence
Infant
Korea*
Long QT Syndrome*
Male
Retrospective Studies*
Sudden Infant Death*
Virulence
DNA
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