Armanni-Ebstein phenomenon and hypothermia

作者：Zhou Chong; Byard Roger W^*

来源：Forensic Science International, 2011, 206(1-3): E82-E84.

DOI：10.1016/j.forsciint.2010.08.018

• Armanni-Ebstein phenomenon
• Renal tubular vacuolization
• Hypothermia
• Diabetes mellitus
• Ketoacidosis

Retrospective review was undertaken of 46 cases of lethal hypothermia for the presence of subnuclear vacuolization of renal tubular epithelial cells. Fifteen of the 46 cases (33%) had renal tubular vacuolization typical of the Armanni-Ebstein phenomenon. The age range was 30-87 years (average 59 years) with amale to female ratio of 6: 9. Nine of the 15 cases with Armanni-Ebstein changes (60%) had a history of diabetes mellitus, and in seven of these vitreous humour biochemical analyses were performed, all of which revealed diabetic ketoacidosis (vitreous glucose levels = 32.9-85.3 mmol/L; beta-hydroxybutyrate = 7.4-20 mmol/L). This study has confirmed the association between hypothermia and renal tubular epithelial vacuolization, but in addition raises the prospect that this may be contributed to in some cases by underlying diabetic ketoacidosis. Hypothermic deaths should, therefore, raise the possibility of diabetes mellitus and initiate postmortem biochemical measurement of vitreous humor glucose and beta-hydroxybutyrate levels.

• 出版日期2011-3-20