title: Use of Cortisol and Adrenal Weight at Pediatric Postmortem.
abstract: We studied the relationship between adrenal weight and postmortem cortisol level in cases of infant death, and examined use of these measurements in adrenal insufficiency. We analyzed procurator-fiscal postmortem reports in the West of Scotland over a three year period. Combined adrenal weight was expressed as percentage of total body weight (%TBW). Of 106 cases, median (5th, 95th) %TBW was 0.056 (0.025, 0.23) and median plasma cortisol was 8.4 ug/dl (1.0, 47.1). There was no correlation between %TBW and plasma cortisol (r = 0.09, p = 0.4). The lowest and highest plasma cortisol quartile had medians of 1.9 ug/dl (1.0, 3.4) and 34.3 ug/dl (17.3, 71.5), respectively. Infection was present in 6 cases (23.1%) in the lowest quartile and in 16 cases (61.5%) in the highest quartile (p = 0.01). Our results highlight the difficulty in interpretation of cortisol at postmortem and suggest that adrenal weight measurement alone may be insufficient for diagnosis of adrenal insufficiency.
authors.affiliation: a Developmental Endocrinology Research Group , University of Glasgow , Glasgow , UK.
authors.forename: Rebecca
authors.identifier: http://orcid.org/0000-0001-6337-1771
authors.initials: R
authors.lastname: Morrison
authors.affiliation: a Developmental Endocrinology Research Group , University of Glasgow , Glasgow , UK.
authors.forename: Jansher
authors.initials: J
authors.lastname: Khan
authors.affiliation: b Department of Biochemistry , Southern General Hospital , Glasgow , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Galloway
authors.affiliation: b Department of Biochemistry , Southern General Hospital , Glasgow , UK.
authors.forename: Jane
authors.initials: J
authors.lastname: McNeilly
authors.affiliation: a Developmental Endocrinology Research Group , University of Glasgow , Glasgow , UK.
authors.forename: Syed Faisal
authors.initials: SF
authors.lastname: Ahmed
authors.affiliation: c Department of Pathology , Southern General Hospital , Glasgow , UK.
authors.forename: Dawn
authors.initials: D
authors.lastname: Penman
mesh_terms: D000311:Adrenal Glands / Q000473:pathology*; D000309:Adrenal Insufficiency / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009929:Organ Size; D012189:Retrospective Studies; D012606:Scotland; D013398:Sudden Infant Death / Q000097:blood* / Q000209:etiology / Q000473:pathology*
chemical_list: D006854:Hydrocortisone
keywords: adrenal insufficiency; adrenal weight; autopsy; cortisol; postmortem