Please use this identifier to cite or link to this item: http://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
RMID: 0030064015
DOI: 10.1111/1556-4029.13311
Appears in Collections:Medicine publications

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