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|Title:||Basal renal tubular epithelial cell vacuolization and alcoholic ketoacidosis|
|Citation:||Journal of Forensic Sciences, 2012; 57(1):126-128|
|Publisher:||Amer Soc Testing Materials|
|Chong Zhou and Roger W. Byard|
|Abstract:||Subnuclear renal tubular epithelial cell vacuolization is a marker for diabetic ketoacidosis. Whether it is because of hyperglycemia or of ketoacidosis is unclear. To examine the effect of ketoacidosis on renal cells in isolation, five cases of lethal alcoholic ketoacidosis without hyperglycemia were examined (vitreous humor β-hydroxybutyrate: 6.42–8.75 mM, mean 7.66 mM; and glucose: 0.1–4.2 mM, mean 1.46 mM). Microscopic examination of the kidneys revealed basal vacuoles in three cases (60%). Seven control cases with acute alcohol toxicity without ketoacidosis (blood alcohol: 0.18–0.43%, mean 0.31%; and β-hydroxybutyrate: 0.12–0.42 mM, mean 0.21 mM) did not have these changes. In this study, basal epithelial vacuolization was found only in cases with significant ketoacidosis. Although the numbers are small, the finding of basal renal tubular epithelial vacuolization in normoglycemic cases with elevated β-hydroxybutyrate levels provide further evidence that disordered lipid metabolism may be involved in the pathogenesis of this phenomenon.|
|Keywords:||forensic science; alcoholic ketoacidosis; intoxication; Armanni–Ebstein phenomenon; diabetes mellitus; alcoholism|
|Rights:||Copyright 2011 American Academy of Forensic Sciences|
|Appears in Collections:||Pathology publications|
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