TY - JOUR
T1 - Postmortem serum uric acid and creatinine levels in relation to the causes of death
AU - Zhu, Bao Li
AU - Ishida, Kaori
AU - Quan, Li
AU - Taniguchi, Mari
AU - Oritani, Shigeki
AU - Li, Dong Ri
AU - Fujita, Masaki Q.
AU - Maeda, Hitoshi
N1 - Funding Information:
This study was, in part, supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Science and Culture, Japan (Grant nos. 11670425 and 12470109).
PY - 2002/1/24
Y1 - 2002/1/24
N2 - Serum uric acid (UA) and creatinine (Cr) mainly derive from skeletal muscle tissues. Although, remarkable postmortem stability of the serum levels has been reported, there appears to be very poor knowledge of the diagnostic value in investigation of death, except for uremia. The aim of the present study was to evaluate postmortem serum UA and Cr levels using 395 forensic autopsy cases, in comparison with blood urea nitrogen (BUN), for investigation of the pathophysiology of death with special regard to the causes of death involving possible skeletal muscle damage, e.g. due to hypoxia, heat or agonal convulsions. Cr and BUN showed relatively good topographic stability in the cadaveric blood, whereas, UA was often much higher in the right heart blood than in the left heart and peripheral blood, independent of postmortem intervals. Moderate to marked elevation of Cr and BUN accompanied with hyperuricemia was observed in delayed death. In the acute death cases (survival time <30min), UA, especially in the right heart blood, showed a considerable elevation in mechanical asphyxiation and drowning. The Cr level in fire victims with a lower carboxyhemoglobin (COHb) level (<60%) was significantly higher than in those with the possible fatal level (>60%). A similar elevation of Cr was observed in fatalities from heat stroke and methamphetamine (MA) poisoning. The observations suggested that hyperuricemia in acute death may be indicative of advanced hypoxia and that elevated Cr level may reflect the skeletal muscle damage, especially due to thermal influence.
AB - Serum uric acid (UA) and creatinine (Cr) mainly derive from skeletal muscle tissues. Although, remarkable postmortem stability of the serum levels has been reported, there appears to be very poor knowledge of the diagnostic value in investigation of death, except for uremia. The aim of the present study was to evaluate postmortem serum UA and Cr levels using 395 forensic autopsy cases, in comparison with blood urea nitrogen (BUN), for investigation of the pathophysiology of death with special regard to the causes of death involving possible skeletal muscle damage, e.g. due to hypoxia, heat or agonal convulsions. Cr and BUN showed relatively good topographic stability in the cadaveric blood, whereas, UA was often much higher in the right heart blood than in the left heart and peripheral blood, independent of postmortem intervals. Moderate to marked elevation of Cr and BUN accompanied with hyperuricemia was observed in delayed death. In the acute death cases (survival time <30min), UA, especially in the right heart blood, showed a considerable elevation in mechanical asphyxiation and drowning. The Cr level in fire victims with a lower carboxyhemoglobin (COHb) level (<60%) was significantly higher than in those with the possible fatal level (>60%). A similar elevation of Cr was observed in fatalities from heat stroke and methamphetamine (MA) poisoning. The observations suggested that hyperuricemia in acute death may be indicative of advanced hypoxia and that elevated Cr level may reflect the skeletal muscle damage, especially due to thermal influence.
KW - Blood urea nitrogen
KW - Creatinine
KW - Forensic pathophysiology
KW - Hyperuricemia
KW - Hypoxia
KW - Skeletal muscle
KW - Thermal injury
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U2 - 10.1016/S0379-0738(01)00617-X
DO - 10.1016/S0379-0738(01)00617-X
M3 - Article
C2 - 11852203
AN - SCOPUS:0037165252
VL - 125
SP - 59
EP - 66
JO - Forensic Science International
JF - Forensic Science International
SN - 0379-0738
IS - 1
ER -