en
Scientific article
English

Ketoacidosis and adrenocortical insufficiency

Published inJournal of forensic sciences, vol. 59, no. 4, p. 1146-1152
Publication date2014
Abstract

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.

Citation (ISO format)
PALMIERE, Cristian et al. Ketoacidosis and adrenocortical insufficiency. In: Journal of forensic sciences, 2014, vol. 59, n° 4, p. 1146–1152. doi: 10.1111/1556-4029.12446
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ISSN of the journal0022-1198
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