Renal cortical pallor--a useful macroscopic marker for metabolic derangements at autopsy.

Abstract:

:Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in eight cases, and alcoholic ketoacidosis in five cases (vitreous humor glucose level≥11.1 mM; β-hydroxybutyrate level≥5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5%), three of eight cases of fatal hyperglycemic nonketotic coma (37.5%), and in two of five cases of alcoholic ketoacidosis (40%). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and osmotic nephrosis in three. Although renal cortical pallor did not appear to be a particularly sensitive marker for hyperglycemia or ketoacidosis, and did not correlate with the severity of these parameters, it may still represent a useful macroscopic marker for underlying metabolic conditions at autopsy and should therefore prompt measurement of vitreous humor glucose and β-hydroxybutyrate levels.

journal_name

J Forensic Sci

authors

Zhou C,Yool A,Byard RW

doi

10.1111/1556-4029.12102

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

693-6

issue

3

eissn

0022-1198

issn

1556-4029

journal_volume

58

pub_type

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