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https://hdl.handle.net/2440/117187
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Type: | Journal article |
Title: | Basal vacuolization in renal tubular epithelial cells at autopsy and their relation to ketoacidosis |
Author: | Zhou, C. Yool, A. Byard, R. |
Citation: | Journal of Forensic Sciences, 2017; 62(3):681-685 |
Publisher: | Wiley |
Issue Date: | 2017 |
ISSN: | 0022-1198 1556-4029 |
Statement of Responsibility: | Chong Zhou, Andrea J. Yool and Roger W. Byard |
Abstract: | Basal vacuolization of renal tubular epithelial cells is a useful postmortem marker for ketoacidosis. To investigate its incidence and relationship to the severity of ketoacidosis, 158 autopsy cases with elevated β-hydroxybutyrate (>1 mmol/L) over a 7-year-period were retrospectively reviewed. Sixty-eight cases (43%) exhibited basal vacuolizations (vitreous β-hydroxybutyrate: 1.16-29.35 mmol/L, mean 10.28 mmol/L), and 90 cases (57%) did not (vitreous β-hydroxybutyrate: 1.03-13.7 mmol/L, mean 2.84 mmol/L). Quantitative analysis revealed on average a fourfold elevation in β-hydroxybutyrate in cases with basal vacuolizations compared to those without; 10.3% of cases with β-hydroxybutyrate concentrations between 1.01 and 2.00 mmol/L had basal vacuolizations, and this incidence increased to 33.3% with concentrations between 4.01 and 6.00 mmol/L. A marked increase in incidence to >70% was observed with concentrations >6.00 mmol/L, and basal vacuoles were invariably present (100%) with concentrations >14.01 mmol/L. This study demonstrates that basal vacuolizations are a sensitive marker for significant ketoacidosis and reaffirms its use as an indicator for likely cases of fatal ketoacidosis at autopsy. |
Keywords: | Forensic science; basal vacuolization; diabetic ketoacidosis; starvation ketoacidosis; alcoholic ketoacidosis; septic ketoacidosis; diabetes mellitus |
Rights: | © 2017 American Academy of Forensic Sciences |
DOI: | 10.1111/1556-4029.13311 |
Published version: | http://dx.doi.org/10.1111/1556-4029.13311 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
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