NCJ Number
239627
Journal
Journal of Forensic Sciences Volume: 57 Issue: 1 Dated: January 2012 Pages: 126-128
Date Published
January 2012
Length
3 pages
Annotation
This article investigates subnuclear renal tubular epithelial cell vacuolization a marker for diabetic ketoacidosis.
Abstract
Subnuclear renal tubular epithelial cell vacuolization is a marker for diabetic ketoacidosis. Whether it is because of hyperglycemia or of ketoacidosis is unclear. To examine the effect of ketoacidosis on renal cells in isolation, five cases of lethal alcoholic ketoacidosis without hyperglycemia were examined (vitreous humor B-hydroxybutyrate: 6.42-8.75 mM, mean 7.66 mM; and glucose: 0.1-4.2 mM, mean 1.46 mM). Microscopic examination of the kidneys revealed basal vacuoles in three cases (60 percent). Seven control cases with acute alcohol toxicity without ketoacidosis (blood alcohol: 0.18-0.43 percent, mean 0.31 percent; and B-hydroxybutyrate: 0.12-0.42 mM, mean 0.21 mM) did not have these changes. In this study, basal epithelial vacuolization was found only in cases with significant ketoacidosis. Although the numbers are small, the finding of basal renal tubular epithelial vacuolization in normoglycemic cases with elevated B-hydroxybutyrate levels provide further evidence that disordered lipid metabolism may be involved in the pathogenesis of this phenomenon. Published by arrangement with John Wiley & Sons.