Postmortem biochemistry in suspected starvation-induced ketoacidosis.

Détails

ID Serval
serval:BIB_5C79D27613A0
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Postmortem biochemistry in suspected starvation-induced ketoacidosis.
Périodique
Journal of forensic and legal medicine
Auteur(s)
Palmiere C., Tettamanti C., Augsburger M., Burkhardt S., Sabatasso S., Lardi C., Werner D.
ISSN
1878-7487 (Electronic)
ISSN-L
1752-928X
Statut éditorial
Publié
Date de publication
08/2016
Peer-reviewed
Oui
Volume
42
Pages
51-55
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Significantly increased blood ketone body levels can be occasionally observed in the forensic setting in situations other than exposure to cold, diabetic or alcoholic ketoacidosis. Though infrequent, these cases do occur and deserve thorough evaluation in order to establish appropriate differential diagnoses and quantify the role that hyperketonemia may play in the death process. Starvation ketoacidosis is a rare cause of metabolic acidosis and is a phenomenon that occurs normally during fasting, as the body switches from carbohydrate to lipid energy sources. The levels of ketonemia in starvation ketoacidosis is usually mild in comparison to those seen in diabetic or alcoholic ketoacidosis. In the clinical setting, several cases of starvation-induced ketoacidosis mainly associated with gastric banding, pregnancy, malnutrition and low-carbohydrate diets have been reported. However, starvation ketosis causing severe metabolic acidosis has been rarely described in the medical literature. In the realm of forensic pathology, starvation-induced hyperketonemia has been rarely described. In this paper we present the postmortem biochemical results observed in situations of suspected starvation-induced hyperketonemia that underwent medico-legal examination. In all these cases, the diagnosis of starvation induced-hyperketonemia and the subsequent ketoacidosis was established per exclusionem based on all postmortem investigation findings. A review of the literature pertaining to the clinical diagnosis of starvation ketoacidosis is also provided.

Mots-clé
3-Hydroxybutyric Acid/metabolism, Acetone/blood, Adult, Albumins/metabolism, Biomarkers/metabolism, Blood Urea Nitrogen, Creatinine/metabolism, Female, Forensic Pathology, Humans, Ketosis/diagnosis, Ketosis/metabolism, Male, Middle Aged, Pericardial Fluid/metabolism, Postmortem Changes, Prealbumin/metabolism, Proteins/metabolism, Starvation/metabolism, Uric Acid/metabolism, Vitreous Body/metabolism
Pubmed
Web of science
Création de la notice
07/06/2016 8:33
Dernière modification de la notice
20/08/2019 15:14
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