Histological demonstration of haemosiderin deposits in lungs and liver from victims of chronic physical child abuse

In the context of chronic physical child abuse, two entities have been desc ribed based on macroscopical and radiological criteria: the battered baby s yndrome and the shaken baby syndrome. However, in some autopsy cases, clini co-radiological information may not be available. In these cases, histologi cal examinations are necessary to look for sequelae of repeated haemorrhage s, particularly in organs likely to have suffered traumatisms such as the l ungs, or in organs belonging to the mononucleated macrophage resorption sys tem, such as the liver and the spleen. We examined a series of 15 young chi ldren who died from proven chronic child abuse and compared them with 15 se x and age-matched control subjects who died from natural causes with no his tory of child abuse. Using Perl's stain for iron, we identified haemosideri n deposits in pulmonary, hepatic and splenic samples and the deposits were evaluated qualitatively and quantitatively. Haemosiderin deposits were sign ificantly (P < 0.001) more abundant in the lungs and liver of the chronic a buse victims than in those of the control subjects. However, they were not significantly more abundant in the spleens of child abuse victims than in c ontrols. We conclude that haemosiderin deposits in lungs and liver could be proposed as a marker for chronic physical child abuse. This study stresses the importance of systematic histological examination to look for pulmonar y and hepatic haemosiderin deposits in cases in which chronic child abuse i s suspected.