Use of Cortisol and Adrenal Weight at Pediatric Postmortem. (4th May 2017)

• Record Type: Journal Article
• Authors: Morrison, Rebecca; Khan, Jansher; Galloway, Peter; McNeilly, Jane; Ahmed, Syed Faisal; Penman, Dawn
• Is Part Of: Fetal and pediatric pathology. Volume 36:Number 3(2017)
• Page Start: 246
• Page End: 255
• Publication Date: 2017-05-04
• Subjects: adrenal insufficiency -- adrenal weight -- autopsy -- cortisol -- postmortem; Pathology, Molecular -- Periodicals; Pediatrics -- Periodicals; Molecular biology -- Periodicals; Pediatric pathology -- Periodicals; Fetal Diseases -- pathology -- Periodicals; Infant, Newborn, Diseases -- pathology -- Periodicals; Pediatrics -- Periodicals; 618.92007
• DOI: 10.1080/15513815.2017.1307475
• Languages: English
• ISSNs: 1551-3815

Abstract

ABSTRACT: We studied the relationship between adrenal weight and postmortem cortisol level in cases of infant death, and examined use of these measurements in adrenal insufficiency. We analyzed procurator-fiscal postmortem reports in the West of Scotland over a three year period. Combined adrenal weight was expressed as percentage of total body weight (%TBW). Of 106 cases, median (5 th, 95 th ) %TBW was 0.056 (0.025, 0.23) and median plasma cortisol was 8.4 ug/dl (1.0, 47.1). There was no correlation between %TBW and plasma cortisol ( r = 0.09, p = 0.4). The lowest and highest plasma cortisol quartile had medians of 1.9 ug/dl (1.0, 3.4) and 34.3 ug/dl (17.3, 71.5), respectively. Infection was present in 6 cases (23.1%) in the lowest quartile and in 16 cases (61.5%) in the highest quartile ( p = 0.01). Our results highlight the difficulty in interpretation of cortisol at postmortem and suggest that adrenal weight measurement alone may be insufficient for diagnosis of adrenal insufficiency.