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Renal Cortical Pallor - A Useful Macroscopic Marker for Metabolic Derangements at Autopsy

NCJ Number
246100
Journal
Journal of Forensic Sciences Volume: 58 Issue: 3 Dated: May 2013 Pages: 693-696
Author(s)
Chong Zhou, M.B.B.S.; Andrea Yool, Ph.D.; Roger W. Byard, M.B.B.S., M.D.
Date Published
May 2013
Length
4 pages
Annotation
Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases.
Abstract
Renal cortical pallor was studied as a potential marker at autopsy of diabetic ketoacidosis in 23 cases, hyperglycemic nonketotic coma in 8 cases, and alcoholic ketoacidosis in 5 cases (vitreous humor glucose level greater than 11.1 mM; -hydroxybutyrate level greater than 5 mM). Renal cortical pallor was noted on macroscopic examination in 10 of 23 cases of lethal diabetic ketoacidosis (43.5 percent), 3 of 8 cases of fatal hyperglycemic nonketotic coma (37.5 percent), and in 2 of 5 cases of alcoholic ketoacidosis (40 percent). Histologic examination revealed basal vacuolization of renal tubular epithelial cells in 12 cases, Armanni-Ebstein lesions in 10, and osmotic nephrosis in 3. 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 -hydroxybutyrate levels. Abstract published by arrangement with John Wiley & Sons.