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Why did my son's ears turned blue, before his death?

Monday, 02 July 2007
Answered by: Dr. Shirish Kumar
Consultant Haematologist,
Sir Ganga Ram Hospital,
New Delhi
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Q. I am a 40-year-old married woman. My 10-year-old son was diagnosed with blood cancer, AML M2 eight months ago. After that, he was admitted in a hospital for 4 months and was given chemotherapy, 4 times. But unfortunately he did not get remission. Two months back, he was discharged from hospital. He was staying with my parents. I was away at that time. Last month, he was again admitted for blood platelets and was subsequently discharged. Next day my son was expired at 8 A.M. When I saw my son's dead body, at 10 A.M,I found both his ears had turned blue in colour. His brain nerve and finger nails were also blue, while other parts of body were natural in colour. I would like to know, why did this happen? What could be the possible cause of ears turning blue?

A.  I am very sorry to learn of your bereavement and can well imagine your state of mind. Unfortunately, acute myeloid leukaemia as a disease, even with current standard chemotherapy regimens, has a 5-year survival rate of only about 25-30%, which is considered a cure. The prognosis is governed by several factors including age of the patient, a prior history of an antecedent haematologic disease (usually a myelodysplastic syndrome), cytogenetic abnormalities and mutations. As the disease affects the cell which gives rise to normal blood cells, patients develop anaemia, infections or bleeding and usually succumb to that. The colour change that you are referring to is called post-mortem lividity. It is a dark purple discolouration of the skin, which results from gravitational pooling of deoxygenated blood in the veins and capillaries of the dependent parts of the body that follows once circulation stops. Lividity is present in all bodies although it may be inconspicuous in some. This pooling of blood occurs because the blood remains liquid due to release of chemicals that prevent it from clotting. Lividity becomes apparent within 30 minutes of death as dull red patches, which gradually deepen in intensity over the next few hours and attains its maximum degree between 8 and 12 hours following death. It is usually well marked in the earlobes and the fingernails.

A.  I am very sorry to learn of your bereavement and can well imagine your state of mind. Unfortunately, acute myeloid leukaemia as a disease, even with current standard chemotherapy regimens, has a 5-year survival rate of only about 25-30%, which is considered a cure. The prognosis is governed by several factors including age of the patient, a prior history of an antecedent haematologic disease (usually a myelodysplastic syndrome), cytogenetic abnormalities and mutations. As the disease affects the cell which gives rise to normal blood cells, patients develop anaemia, infections or bleeding and usually succumb to that. The colour change that you are referring to is called post-mortem lividity. It is a dark purple discolouration of the skin, which results from gravitational pooling of deoxygenated blood in the veins and capillaries of the dependent parts of the body that follows once circulation stops. Lividity is present in all bodies although it may be inconspicuous in some. This pooling of blood occurs because the blood remains liquid due to release of chemicals that prevent it from clotting. Lividity becomes apparent within 30 minutes of death as dull red patches, which gradually deepen in intensity over the next few hours and attains its maximum degree between 8 and 12 hours following death. It is usually well marked in the earlobes and the fingernails.

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