Ketoacidosis and Adrenocortical Insufficiency. Issue 4 (19th February 2014)

• Record Type: Journal Article
• Authors: Palmiere, Cristian; de Froidmont, Sébastien; Mangin, Patrice; Werner, Dominique; Lobrinus, Johannes A.
• Is Part Of: Journal of forensic sciences. Volume 59:Issue 4(2014)
• Page Start: 1146
• Page End: 1152
• Publication Date: 2014-02-19
• Subjects: Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; 363.2505
• DOI: 10.1111/1556-4029.12446
• Languages: English
• ISSNs: 0022-1198

Abstract

<abstract abstract-type="main" id="jfo12446-abs-0001"> <title>Abstract</title> <p>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.</p> </abstract>