Fatty degeneration of myocardial cells as a sign of death due to hypothermia versus degenerative deposition of lipofuscin

Preuß, J.; Dettmeyer, R.; Lignitz, Eberhard; Madea, Burkhard

doi:10.1016/j.forsciint.2005.06.001

Cited by 30 publications

(14 citation statements)

References 9 publications

(11 reference statements)

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“…Histology Histological changes that have been attributed to fatal general hypothermia include necrosis of pancreatic cells with leukocyte infiltration, vacuolization of hepatocytes, adrenal, adenoid pancreatic and renal cells, hypoxic cardiac changes and fatty changes of cardiac myocytes, hepatocytes and renal tubular cells [119][120][121][122]. The highest diagnostic value can be attributed to fatty degeneration of the renal tubular epithelium [120].…”

Section: Further Postmortem Examinationsmentioning

confidence: 99%

Hypothermia

Türk

2010

Forensic Sci Med Pathol

135

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Hypothermia refers to a situation where there is a drop in body core temperature below 35 degrees C. It is a potentially fatal condition. In forensic medicine and pathology, cases of hypothermia often pose a special challenge to experts because of their complex nature, and the often absent or nonspecific nature of morphological findings. The scene of the incident may raise suspicions of a crime initially, due to phenomena such as terminal burrowing behavior and paradoxical undressing. An element of hypothermia often contributes to the cause of death in drug- and alcohol-related fatalities, in the homeless, in immersion deaths, in accidents and in cases of abuse or neglect, making the condition extremely relevant to forensic medical specialists. The aim of this review is to give an overview of the pathophysiological aspects of hypothermia and to illustrate different aspects relevant to forensic medical casework.

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Section: Further Postmortem Examinationsmentioning

confidence: 99%

Hypothermia

Türk

2010

Forensic Sci Med Pathol

135

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“…However, reports of forensic hypothermia investigations using molecular biological methods have only recently begun to appear, and existing hypothermia findings are also important (Turk, 2010). In addition, fatty degeneration of renal tubular epithelium (Preuss et al, 2004) and myocardial cells (Preuss et al, 2006), vacuoles in pancreatic adenoid cells (Preuss et al, 2007), and heat shock protein 70 in renal tubular epithelium and glomerular podocytes (Preuss et al, 2008) can be used as markers of hypothermia. In forensic practice, considering the combination of macroscopic, microscopic, and molecular biologic observations would be conducive to a more accurate diagnosis of hypothermia.…”

Section: Discussionmentioning

confidence: 99%

DNA Microarray Analysis of the Mouse Adrenal Gland for the Detection of Hypothermia Biomarkers: Potential Usefulness for Forensic Investigation

Takamiya¹,

Saigusa²,

Dewa³

2013

Therapeutic Hypothermia and Temperature Management

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We analyzed the adrenal gland transcriptome of mice killed by hypothermia using DNA microarray technology. A total of 4051 significantly expressed genes were identified; 2015 genes were upregulated and 2036 were downregulated. The FBJ osteosarcoma oncogene was the most upregulated, whereas stearoyl coenzyme A desaturase 3 was the most downregulated. Validation by quantitative polymerase chain reaction revealed that results obtained by both methods were consistent. In the gene set analysis, significant variations were found in nine pathways, and we suggest that transforming growth factor b and tumor necrosis factor a would be involved in the pathogenesis of hypothermia. Gene functional category analysis demonstrated the most overexpressed categories in upregulated and downregulated genes were cellular process in biological process, binding in molecular function, and cell and cell part in cellular component. The present study demonstrated acute adrenal responses in hypothermia, and we suggest that understanding adrenal mRNA expression would be useful for hypothermia diagnosis. Furthermore, the present microarray data may also facilitate development of immunohistochemical analysis of human cases. In forensic practice, the combination of macroscopic and microscopic observations with molecular biological analyses would be conducive to more accurate diagnosis of hypothermia. Although this study is aimed at forensic practice, the present data regarding more than 20,000 genes of the adrenal gland would be beneficial to inform future clinical hypothermia research. From the viewpoint of adrenal gene activity, they could contribute to elucidating the pathophysiology of hypothermia.

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“…In the literature of fatal hypothermia cases, several histological findings have been described such as the fatty degeneration of the renal tubular epithelium (subnuclear vacuolization of renal tubular epithelial cells or the Armanni-Ebstein phenomenon) [1,[28][29][30]; pancreatic cell necrosis with leukocyte infiltration; vacuolization of anterior pituitary gland cells, hepatocytes, pancreatic adenocytes, and adrenal and renal cells; hypoxic cardiac changes; fatty changes of cardiac myocytes, hepatocytes, and renal tubular cells [28][29][30][31][32][33][34]. The fatty degeneration of the renal tubular epithelium has been indicated as the most reliable histological finding used to diagnose hypothermia [1,28]; other histological features that were described in literature have been rejected in more recent studies [35].…”

Section: Introductionmentioning

confidence: 99%

Postmortem biochemical investigations in hypothermia fatalities

Palmière

Mangin

2012

Int J Legal Med

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Despite the progress made during the past several decades in forensic pathology, the possibilities for the postmortem diagnosis of hypothermia remains relatively limited. Aside from histology and immunohistochemistry, numerous authors have investigated the postmortem biochemistry of hypothermia fatalities. Several biochemical markers (e.g., glucose, electrolytes, hormones, ketone bodies, and neurotransmitters) and various biological samples (e.g., blood, urine, heart, liver, skeletal muscle as well as pericardial and cerebrospinal fluids) have been proposed as potentially useful markers to improve the insufficient diagnostic efficacy of macroscopic and microscopic findings. The aim of this article is to review the medicolegal literature covering the postmortem biochemical investigations that are associated with hypothermia cases as well as report our own research results on this topic where possible.

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Fatty degeneration of myocardial cells as a sign of death due to hypothermia versus degenerative deposition of lipofuscin

Cited by 30 publications

References 9 publications

Hypothermia

Hypothermia

DNA Microarray Analysis of the Mouse Adrenal Gland for the Detection of Hypothermia Biomarkers: Potential Usefulness for Forensic Investigation

Postmortem biochemical investigations in hypothermia fatalities

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