After installing KB2769165, ASP.NET MVC4 applications have started getting FatalExecutionEngineErrors (error code 0xc0000005) when loading the first page - VS2012 shows the exception being thrown from AreaRegistration.RegisterAllAreas() called from Application_Start.
Commenting out the RegisterAllAreas call causes the same error to be thrown somewhere between Application_Start (which does return) and the controller action. The only location on the call stack at the time of the error is mscorlib.dll!System.Reflection.RuntimeModule.GetTypes() + 0x14 bytes.
This applies even with new MVC4 applications based on the Internet Application and Basic templates (probably any MVC4 application, really).
I get the same results on two different computers, one running Windows 8 Pro and the other one running Windows 8 Enterprise (on dissimilar hardware). The error shows up both when using IIS8 Express and the Visual Studio Development Server, and both when debugging or simply running the application without debugging.
The only workaround I have found is to uninstall and block KB2769165, which this works perfectly repeatably.