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Type: Journal article
Title: Basal renal tubular epithelial cell vacuolization and alcoholic ketoacidosis
Author: Zhou, C.
Byard, R.
Citation: Journal of Forensic Sciences, 2012; 57(1):126-128
Publisher: Amer Soc Testing Materials
Issue Date: 2012
ISSN: 0022-1198
Statement of
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
RMID: 0020116229
DOI: 10.1111/j.1556-4029.2011.01957.x
Appears in Collections:Pathology publications

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