Evaluation of Serum Cortisol in the Postmortem Diagnosis of Acute Adrenal Insufficiency

Clapper, Adam T.; Nashelsky, Marcus; Dailey, Morris O.

doi:10.1097/paf.0b013e318174e7c8

Cited by 18 publications

(19 citation statements)

References 10 publications

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“…Adreno-cortical insufficiency can arise spontaneously, as part of a syndrome, in the context of sepsis or as a result of steroid therapy, and result in death [291,[388][389][390][391]. Abnormal pigmentation of the gingival membranes and skin creases may be apparent in Addison's disease [389].…”

Section: Central Nervous System Causes Of Sudden Deathmentioning

confidence: 98%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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In the investigation of sudden death in adults, channelopathies, such as long QT syndrome, have risen to the fore in the minds of forensic pathologists in recent years. Examples of these disorders are touched upon in this review as an absence of abnormal findings at postmortem examination is characteristic and the importance of considering the diagnosis lies in the heritable nature of these conditions. Typically, a diagnosis of a possible channelopathy is evoked as an explanation for a 'negative autopsy' in a case of apparent sudden natural death. However, the one potential adverse effect of this approach is that subtle causes of sudden death may be overlooked. The intention of this article is to review and discuss potential causes of sudden adult death (mostly natural) that should be considered before resorting to a diagnosis of possible channelopathy. Nonetheless, it becomes apparent that many of the potential causes of sudden death can have a genetic basis. Thus, it becomes an important consideration that there may be a genetic basis to sudden death that extends beyond the negative autopsy.

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Section: Central Nervous System Causes Of Sudden Deathmentioning

confidence: 98%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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“…Although concerning this, suppressive effect of stress hormone on immune system has been generally suggested, it would be not sufficient for explanation of stress-induced cancer. Indeed, several epidemiological analysis indicate that stress can increase the incidence of various kinds of human cancers including colon and lung cancer [13, 14]. …”

Section: Introductionmentioning

confidence: 99%

Prevention effect of rare ginsenosides against stress-hormone induced MTOC amplification

et al. 2016

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Stress has been suggested as one of important cause of human cancer without molecular biological evidence. Thus, we test the effect of stress-related hormones on cell viability and mitotic fidelity. Similarly to estrogen, stress hormone cortisol and its relative cortisone increase microtubule organizing center (MTOC) number through elevated expression of γ-tubulin and provide the Taxol resistance to human cancer cell lines. However, these effects are achieved by glucocorticoid hormone receptor (GR) but not by estrogen receptor (ER). Since ginsenosides possess steroid-like structure, we hypothesized that it would block the stress or estrogen-induced MTOC amplification and Taxol resistance. Among tested chemicals, rare ginsenoside, CSH1 (Rg6) shows obvious effect on inhibition of MTOC amplification, γ-tubulin induction and Taxol resistance. Comparing to Fulvestant (FST), ER-α specific inhibitor, this chemical can block the cortisol/cortisone-induced MTOC deregulation as well as ER-α signaling. Our results suggest that stress hormone induced tumorigenesis would be achieved by MTOC amplification, and CSH1 would be useful for prevention of stresshormone or steroid hormone-induced chromosomal instability.

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“…The availability of appropriately stored antemortem serum samples is of great importance, and cortisol is sufficiently stable in postmortem blood [6]. Levels of cortisol, 17-hydroxycorticosterone, aldosterone, and dehydroepiandrosterone in postmortem serum from femoral blood and urine (in combination with other biochemical investigation) allow for the differentiation between ketoacidosis and adrenocortical insufficiency [7].…”

Section: Clinical Management Of Adrenal Tumorsmentioning

confidence: 99%

Sudden Death due to Diseases of the Adrenal Glands and Paraganglia

Visonà¹,

Tajana²,

Osculati³

2017

Clinical Management of Adrenal Tumors

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Coroners and pathologists commonly evaluate unexpected deaths due to diseases of the adrenal glands and paraganglia, which are, unfortunately, not rare in their totality. Although cardiac causes are the main cause of sudden death, endocrine conditions can produce sudden, unexpected deaths that need further investigation, especially in younger patients. This chapter focuses on the issue of sudden death due to diseases involving adrenal glands and paraganglia. The main causes of sudden death due to adrenal gland pathology will be examined, paying particular attention to the pathophysiology of sudden death, macroscopic and microscopic characteristics and their correlation with clinical features. These issues are of great interest, especially considering the clinical impact of sudden death and its rarity among patients with adrenal gland diseases. The forensic pathologist's examination is extremely important in determining the cause of death and findings not clinically observable and can contribute to the improvement of the clinical and surgical approach in treating such patients.

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Evaluation of Serum Cortisol in the Postmortem Diagnosis of Acute Adrenal Insufficiency

Cited by 18 publications

References 10 publications

Sudden adult death

Sudden adult death

Prevention effect of rare ginsenosides against stress-hormone induced MTOC amplification

Sudden Death due to Diseases of the Adrenal Glands and Paraganglia

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