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Review
. 2025 Sep;21(3):1358-1369.
doi: 10.1007/s12024-024-00934-0. Epub 2025 Jan 9.

Immunohistochemical insights into hypothermia-related deaths: a systematic review

Luca Tomassini  1 , Massimo Lancia  2 , Cristiana Gambelunghe  2 , Giulia Ricchezze  3 , Piergiorgio Fedeli  4 , Mariano Cingolani  5 , Francesco De Micco  6 , Elena Fiorucci  2 , Roberto Scendoni  5
Affiliations
Review

Immunohistochemical insights into hypothermia-related deaths: a systematic review

Luca Tomassini et al. Forensic Sci Med Pathol. 2025 Sep.

Abstract

Purpose: Hypothermia occurs when core body temperature drops below 35 °C. The purpose of this review was to identify and analyze studies on the topic of hypothermia from an immunohistochemical perspective to determine robust markers of fatal hypothermia.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. It has been registered with Prospero (registration number: CRD42024572782).

Results: In total, 2618 publications met the search criteria. A total of 63 duplicate articles were excluded and a further 2489 publications were excluded for not meeting the inclusion criteria, leaving 29 full-text articles. Furthermore, from the bibliographies of the included articles, four more publications were selected, which also respected the established inclusion and exclusion criteria. Only six studies identified a statistically significant correlation between immunohistochemical patterns and hypothermia-related deaths.

Conclusion: The existing literature examined appears fragmented and lacks robust statistical validation. Therefore, there is an evident need for more comprehensive and methodologically rigorous research to develop reliable diagnostic criteria.

Keywords: Cold-related deaths; Forensic autopsy; Hypothermia; Immunohistochemistry; Parenchymal analysis..

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Descriptive diagram of the paper selection process
Fig. 2
Fig. 2
Bar graph summary of the results obtained
See this image and copyright information in PMC

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