Postmortem Urinary Cortisol Levels in Relation to the Cause of Death

Lang, Lotte Markussen; Línnet, Kristían

doi:10.4172/2157-7145.1000189

Cited by 1 publication

(2 citation statements)

References 22 publications

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“…Postmortem urinary cortisol values are as reliable as the blood specimens. 16 In our case, detailed medical history and medical records were available, including laboratory analysis performed at the time of the admission (antemortem blood samples), which were consistent with an adrenal crisis. Vitiligo and elevated titers of thyroid peroxidase antibodies further supported an autoimmune process as the cause of the primary adrenal insufficiency.…”

Section: Not Reportedmentioning

confidence: 74%

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Death Due to Adrenal Crisis

Gitto

Stoppacher²,

Serinelli³

2021

Am J Forensic Med Pathol

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Adrenal crisis is a life-threatening manifestation of acute adrenal insufficiency. One of the most important underlying causes is Addison disease (primary adrenal insufficiency).A 42-year-old White woman with a medical history of Addison disease on chronic steroid therapy was admitted to the emergency department due to sustained episodes of cardiopulmonary arrest. Upon admission, she was hypotensive and hypoglycemic. Despite resuscitation attempts, she developed multiorgan failure and eventually died. At autopsy, no definitive adrenal gland tissue was grossly identified, but histology detected atrophy of adrenal glands with patchy chronic inflammation. Evidence of acute pneumonia was seen. The cause of death was determined to be complications of adrenal/Addisonian crisis.A review of the literature showed only a few autopsy studies regarding deaths due to adrenal crisis. Forensic pathologists should include adrenal crisis in their differential diagnosis. Adequate medical history and pertinent autopsy findings can corroborate deaths due to adrenal crisis, but exhaustive biochemical analyses are mandatory to support the diagnosis further.

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Section: Not Reportedmentioning

confidence: 74%

“…Extremely low cortisol levels in the postmortem blood sample in the appropriate clinical/forensic setting can support the diagnosis. Postmortem urinary cortisol values are as reliable as the blood specimens 16 …”

Section: Discussionmentioning

confidence: 99%