Journal article
Evaluation of serum cortisol in the postmortem diagnosis of acute adrenal insufficiency
The American journal of forensic medicine and pathology, Vol.29(2), pp.181-184
06/2008
DOI: 10.1097/PAF.0b013e318174e7c8
PMID: 18520491
Abstract
Normal adrenocortical activity is necessary for electrolyte regulation and the maintenance of cardiovascular function. Although chronic adrenal insufficiency generally presents with the gradual onset of a set of characteristic symptoms and signs, the more sudden loss of adrenal activity can present with acute, rapidly progressive cardiovascular dysfunction that can be fatal if not recognized and treated promptly. We herein describe a patient who had most of his adrenal tissue removed during resection of metastatic renal carcinoma, conventional clear cell type, with much of the remaining adrenal tissue undergoing necrosis during or shortly after surgery. Although the patient appeared to be stable and progressing adequately well, he died suddenly 2 days postoperatively. When the gross autopsy findings suggested the possibility of adrenal insufficiency, clinical laboratory assessment of adrenocortical activity was sought. Analysis of stored antemortem serum samples and of blood obtained at autopsy demonstrated a progressive decrease in cortisol levels which, in this stressed postsurgical patient, proved fatal. The use of both antemortem and postmortem blood in the demonstration of acute adrenal insufficiency at autopsy is discussed.
Details
- Title: Subtitle
- Evaluation of serum cortisol in the postmortem diagnosis of acute adrenal insufficiency
- Creators
- Adam Clapper - Department of Pathology, University of Iowa, Iowa City, Iowa 52242, USA. adam-clapper@uiowa.eduMarcus NashelskyMorris Dailey
- Resource Type
- Journal article
- Publication Details
- The American journal of forensic medicine and pathology, Vol.29(2), pp.181-184
- Publisher
- United States
- DOI
- 10.1097/PAF.0b013e318174e7c8
- PMID
- 18520491
- ISSN
- 0195-7910
- eISSN
- 1533-404X
- Language
- English
- Date published
- 06/2008
- Academic Unit
- Epidemiology; Pathology
- Record Identifier
- 9984047689102771
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