Hyperthermia and postmortem biochemical investigations.
The postmortem diagnosis of heat-related deaths presents certain difficulties. Firstly, preterminal or terminal body temperatures are often not available. Additionally, macroscopic and microscopic findings are nonspecific or inconclusive and depend on survival duration after exposure. The diagnosis of hyperthermia is therefore essentially based on scene investigation, the circumstances of death, and the reasonable exclusion of other causes of death. Immunohistochemistry and postmortem biochemical investigations have been performed by several authors in order to better circumstantiate the physiopathology of hyperthermia and provide further information to confirm or exclude a heat-related cause of death. Biochemical markers, such as electrolytes, hormones, blood proteins, enzymes, and neurotransmitters, have been analyzed in blood and other biological fluids to improve the diagnostic potential of autopsy, histology, and immunohistochemistry. The aim of this article is to present a review of the medicolegal literature pertaining to the postmortem biochemical investigations that are associated with heat-related deaths.
University Centre of Legal Medicine, Rue du Bugnon 21, 1011, Lausanne, Switzerland. cristian.palmiere@chuv.ch
Cristian
C
Palmiere
Patrice
P
Mangin
D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000134:cerebrospinal fluid; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000032:analysis; D001806:Blood Urea Nitrogen; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D002118:Calcium / Q000032:analysis; D002395:Catecholamines / Q000032:analysis; D002712:Chlorides / Q000032:analysis; D053379:Chromogranin A / Q000097:blood / Q000134:cerebrospinal fluid; D052279:Creatine Kinase, MB Form / Q000097:blood / Q000134:cerebrospinal fluid; D003404:Creatinine / Q000097:blood; D004573:Electrolytes / Q000032:analysis; D005334:Fever / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000652:urine; D049429:Forensic Pathology; D013006:Growth Hormone / Q000097:blood / Q000134:cerebrospinal fluid; D018883:Heat Stroke / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000652:urine; D006801:Humans; D008274:Magnesium / Q000032:analysis; D009206:Myocardium / Q000473:pathology; D009211:Myoglobin / Q000032:analysis; D009212:Myoglobinuria / Q000175:diagnosis / Q000209:etiology; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000134:cerebrospinal fluid; D019798:Neopterin / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D012964:Sodium / Q000032:analysis; D014336:Troponin / Q000097:blood / Q000134:cerebrospinal fluid; D053802:Tryptases / Q000097:blood; D014527:Uric Acid / Q000032:analysis; D014822:Vitreous Body / Q000737:chemistry
D015415:Biomarkers; D002395:Catecholamines; D002712:Chlorides; D053379:Chromogranin A; D004573:Electrolytes; D009211:Myoglobin; D011498:Protein Precursors; D014336:Troponin; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D019798:Neopterin; D009320:Atrial Natriuretic Factor; D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone; D002116:Calcitonin; D002097:C-Reactive Protein; D012964:Sodium; D003404:Creatinine; D052279:Creatine Kinase, MB Form; D053802:Tryptases; D008274:Magnesium; D002118:Calcium