Ketoacidosis and Adrenocortical Insufficiency

被引：4

作者：

Palmiere, Cristian ^{[1
]}

de Froidmont, Sebastien ^{[1
]}

Mangin, Patrice ^{[1
]}

Werner, Dominique ^{[2
]}

Lobrinus, Johannes A. ^{[3
]}

机构：

[1] Univ Ctr Legal Med, CH-1011 Lausanne, Switzerland

[2] Univ Lausanne Hosp, Clin Chem Lab, CH-1011 Lausanne, Switzerland

[3] Univ Hosp Geneva, Div Clin Pathol, CH-1211 Geneva, Switzerland

来源：

JOURNAL OF FORENSIC SCIENCES | 2014年 / 59卷 / 04期

关键词：

forensic sciences; adrenocortical insufficiency; Addisonian crisis; postmortem biochemistry; ketoacidosis; fasting; POSTMORTEM CHEMISTRY UPDATE; AUTOIMMUNE ADDISONS-DISEASE; ADRENAL INSUFFICIENCY; STARVATION KETOACIDOSIS; CRISIS; DIAGNOSIS; PATIENT; DEATH;

D O I：

10.1111/1556-4029.12446

中图分类号：

DF [法律]; D9 [法律]; R [医药、卫生];

学科分类号：

0301 ; 10 ;

摘要：

We herein report an autopsy case involving a 27-year-old Caucasian woman suffering from chronic adrenocortical insufficiency with a background of a polyendocrine disorder. Postmortem biochemistry revealed pathologically decreased aldosterone, cortisol, and dehydroepiandrosterone levels in postmortem serum from femoral blood as well as decreased cortisol and 17-hydroxycorticosteroid in urine. Decreased vitreous sodium and increased 3-beta-hydroxybutyrate and C-reactive protein concentrations were observed. The cause of death was determined to be acute adrenocortical insufficiency. Fasting ketoacidosis was postulated to have precipitated the Addisonian crisis. Traumatic causes of death and third-party involvement were excluded. The case highlights the importance of systematically performing exhaustive postmortem biochemical investigations to formulate appropriate hypothesis regarding the pathophysiological mechanisms involved in the death process.

引用

页码：1146 / 1152

页数：7

共 49 条

[1]

Akçay MN, 2003, INT J CLIN PRACT, V57, P840

[2] Primary adrenal failure due to viral infection in an infant [J].