title: Detection of ketosis in vitreous at autopsy after embalming.
abstract: Ketosis occurs in ketoacidosis or malnourishment. When either is suspected in relation to a death, it may be important to analyze for ketosis at autopsy. We encountered a case where starvation was suspected in a deceased nursing home resident, where the body had been embalmed prior to autopsy. Gas chromatography (GC) was unable to separate acetone from formaldehyde, a component of embalming fluid. The Acetest is a simple test that can detect acetone and acetoacetate in body fluids. We validated the Acetest with GC on vitreous. The Acetest and GC were consistent except at very low levels of acetone or acetoacetate. The sensitivity of the Acetest for acetoacetate in vitreous was 10 mg/dL, consistent with early starvation. Significant interference from embalming fluid did not occur. The Acetest was negative in the described case. The Acetest is a simple and useful test for the detection of ketosis in embalmed autopsies.
authors.affiliation: Department of Pathology, University of Alabama at Birmingham, 35233, USA.
authors.forename: Jon R
authors.initials: JR
authors.lastname: Steinhauer
authors.forename: Andrea
authors.initials: A
authors.lastname: Volk
authors.forename: Robert
authors.initials: R
authors.lastname: Hardy
authors.forename: Robert
authors.initials: R
authors.lastname: Konrad
authors.forename: Tom
authors.initials: T
authors.lastname: Daly
authors.forename: C Andrew
authors.initials: CA
authors.lastname: Robinson
mesh_terms: D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D004615:Embalming; D005554:Forensic Medicine / Q000379:methods; D006801:Humans; D007662:Ketosis / Q000175:diagnosis* / Q000209:etiology; D013048:Specimen Handling; D013217:Starvation / Q000150:complications / Q000175:diagnosis*; D014822:Vitreous Body / Q000737:chemistry