AI Article Synopsis
- A 27-year-old Caucasian woman with chronic adrenal insufficiency died, and her autopsy revealed low levels of key hormones like aldosterone and cortisol.
- Postmortem tests showed signs of metabolic distress, including dehydration and markers of inflammation, suggesting a severe lack of adrenal function leading to death.
- The case emphasizes the need for thorough biochemical testing after death to better understand the underlying health issues and causes of death.
Article Abstract
We herein report an autopsy case involving a 27-year-old Caucasian woman suffering from chronic adrenocortical insufficiency with a background of a polyendocrine disorder. Postmortem biochemistry revealed pathologically decreased aldosterone, cortisol, and dehydroepiandrosterone levels in postmortem serum from femoral blood as well as decreased cortisol and 17-hydroxycorticosteroid in urine. Decreased vitreous sodium and increased 3-beta-hydroxybutyrate and C-reactive protein concentrations were observed. The cause of death was determined to be acute adrenocortical insufficiency. Fasting ketoacidosis was postulated to have precipitated the Addisonian crisis. Traumatic causes of death and third-party involvement were excluded. The case highlights the importance of systematically performing exhaustive postmortem biochemical investigations to formulate appropriate hypothesis regarding the pathophysiological mechanisms involved in the death process.
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| http://dx.doi.org/10.1111/1556-4029.12446 | DOI Listing |
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Article Synopsis
- - Adrenocortical insufficiency is a serious condition caused by a lack of glucocorticoids and/or mineralocorticoids from the adrenal cortex, leading to life-threatening adrenal crises, requiring immediate hydrocortisone treatment.
- - Symptoms like low blood pressure, weight loss, and fatigue are often vague, causing delays in diagnosis; the case study involves a 43-year-old woman who experienced adrenal insufficiency due to bleeding in her adrenal glands while also having immune thrombocytopenia (ITP).
- - Proper diagnosis is crucial, especially in patients with bleeding risk factors, and treatment typically starts with high doses of hydrocortisone and possibly fludrocortisone, which can later be adjusted as
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