Further Investigations on the Hypothesis that some Cases of Cot-Death are Due to a Modified Anaphylactic Reaction to Cow's Milk

Abstract

The antibody titers to cow''s milk proteins measured by the coated tanned cell agglutination test in a further series of 38 cases of cot-death tended to be higher than the average titer in the sera of normal infants of the same age. There is some evidence that the sera from some cases of cot death may have "incomplete" antibodies to cow''s milk proteins undetected by the antigen coated tanned cell test. Milk protein has been demonstrated in a high proportion of cot-death lungs and also in the serum of some cot-death cases. Casein has not been demonstrated in the lungs, and only in low concentration in 3 samples of serum of cot-death cases. Evidence for anaphylactic death could be shown in guinea-pig lungs up to 30 minutes after death, but in 6 cot-death cases no definite evidence of bronchial constriction could be shown though some obstruction of the airway was present in 2 cases. Attempts to show the presence of an eosinophil-stimulating substance in the lungs of cot-death cases, as an indication of an anaphylactic dea were unsuccessful. Examination of the mast cells of cot-death lungs revealed no widespread changes associated with anaphylaxis. Some preliminary experiments on anaphylaxis in the baboon (Papio cyanocephalus) in an attempt to reproduce the pattern of changes occurring in cot-death are reported in an appendix. In 8 cases of cot-death, specially chosen for the freshness of the post mortem material, no evidence of virus was found.