Lethal abusive head trauma in infancy in Denmark from 2000 to 2011.

INTRODUCTION: We aimed to estimate the incidence of lethal abusive head trauma (AHT) in infancy in Denmark from 2000 through 2011 and to describe autopsy findings and information from police reports on lethal AHT cases. METHODS: This was a nationwide retrospective study. We identified AHT cases in the National Cause of Death Register (CODR) and in forensic archives and compared data from the two sources. Moreover, we collected data on medical history, witness statements and conviction reports from police files and the Director of Public Prosecutions. RESULTS: We identified eight cases of lethal infant AHT (incidence: 1.04 per 100,000 person years). Three AHT cases from autopsy reports were not registered correctly in the CODR. The median age of the victims was 46.5 days. They all had recent subdural and/or subarachnoid haemorrhage. We also found a high prevalence of retinal haemorrhage and fractures. Seven perpetrators were identified, all male relatives, and all were convicted. We moreover identified a surprisingly large number of infants with unspecific cause of death and missing information on whether an autopsy had been performed in the CODR (n = 56). CONCLUSIONS: The incidence of lethal infant AHT found in this study is lower than findings from most other countries. Data from the CODR are inadequate for identifying all lethal AHTs. Further studies including non-fatal cases of AHT are needed to determine the real incidence of AHT in Denmark. FUNDING: none. TRIAL REGISTRATION: not relevant.

[Progressive muscular atrophy in a ten-year-old girl]. / Progredierende muskelsvind hos en tiårig pige.

Chronic inflammatory demyelinating polyneuropathy, CIDP, is a rare differential diagnosis to the hereditary myopathies but because it can be treated effectively it is important to consider. A ten-year-old girl's proximal muscle groups debilitated progressively, and in four months she lost the ability to walk. Stretch reflexes were absent, creatine kinase low and spinal protein elevated. Muscle biopsy showed demyelinating atrophy. CIDP was diagnosed and she was successfully treated with immunoglobulin.