Postmortem diagnosis of hyponatremia: case report and literature review

Vanhaebost, Jessica; Palmière, Cristian; Scarpelli, Maria Pia; Abdallah, Fahed; Capron, Arnaud; Schmit, G.

doi:10.1007/s00414-017-1601-y

Cited by 9 publications

(3 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At necropsy, 24-h following the carcass report, vitreous humor was collected to serve as a proxy for serum (19,27,28). The vitreous was red-tinged, indicating possible blood contamination, most likely related to retinal or fundic hemorrhage associated with drowning/asphyxiation (29).…”

Section: Case Description and Analytical Methodsmentioning

confidence: 99%

Health Impacts and Recovery From Prolonged Freshwater Exposure in a Common Bottlenose Dolphin (Tursiops truncatus)

et al. 2020

View full text Add to dashboard Cite

Common bottlenose dolphins (Tursiops truncatus) exposed to freshwater or low salinity (<10 practical salinity units; PSU) for prolonged periods of time have been documented to develop skin lesions, corneal edema and electrolyte abnormalities, and in some instances they have died. Here we review a case of an out-of-habitat subadult, female common bottlenose dolphin that remained in a freshwater lake in Seminole, Alabama for at least 32 days. Due to concerns for the dolphin's health a rescue was initiated. At the time of rescue bloodwork results indicated minor electrolyte abnormalities (hyponatremia, hypochloremia, hypoosmolality). Renal function was not affected (normal creatinine and urea nitrogen) and all other bloodwork parameters (hemogram; serum biochemistry analytes) were within normal limits. The dolphin was deemed healthy enough for immediate relocation and release. A satellite-linked tag was attached to the dorsal fin to track the dolphin following its relocation to a nearby brackish water bay (Perdido Bay, AL), a known habitat for bottlenose dolphins. Twelve weeks following release, the dolphin was found dead as a result of a fisheries interaction (peracute underwater entrapment). A full necropsy was conducted and there was complete resolution of the skin pallor and skin lesions and no evidence of chronic renal or central nervous system lesions. Post-mortem analysis of vitreous humor (used as a proxy for serum analytes and to determine post-mortem interval) was challenging to interpret and has not been validated in dolphins. This supports the need for future research in cetaceans to establish a species-specific approach. Elevated barium (Ba) concentrations in tooth dentin corresponded to increased seasonal freshwater discharge patterns, confirming repeated annual exposure to low salinity conditions prior to death and indicating freshwater exposure may pose an ongoing threat to dolphins in the region. This case provides a unique opportunity to follow the progression of prolonged freshwater exposure and recovery in a bottlenose dolphin and highlights that dolphins in nearshore habitats face a combination of persistent natural and human associated threats.

show abstract

Section: Case Description and Analytical Methodsmentioning

confidence: 99%

Health Impacts and Recovery From Prolonged Freshwater Exposure in a Common Bottlenose Dolphin (Tursiops truncatus)

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Vitreous sodium levels remain relatively stable, particularly during the early postmortem period, and are similar to serum concentrations in living subjects [23–25]. As the postmortem interval lengthens, slow diffusion of sodium ions takes place from the vitreous humor into surrounding retinal and choroidal cells, with a 2.2 mmol/L reduction per day [25].…”

Section: Discussionmentioning

confidence: 99%

Subnuclear renal tubular vacuoles in alcohol use disorder

Auld

Parai

Milroy

2023

Journal of Forensic Sciences

View full text Add to dashboard Cite

Subnuclear vacuoles in the proximal renal tubules have been reported as a histologic sign of ketoacidosis. Originally described in diabetic ketoacidosis, renal vacuoles can be found in other ketogenic states such as alcoholic ketoacidosis (AKA), starvation, and hypothermia, underpinned by deranged fatty acid metabolism. A retrospective analysis of 133 deaths associated with alcohol use disorder (AUD) examined at autopsy between 2017 and 2020 was undertaken. This study aimed to determine the prevalence of subnuclear vacuoles in deaths of those with AUD and their specificity for deaths from AKA, and to elucidate what demographic, biochemical, and pathologic findings are associated with subnuclear vacuoles. In each case, vitreous humor biochemistry including electrolytes, glucose, and beta‐hydroxybutyrate (BHB) was analyzed alongside postmortem hemoglobin A1c and renal and liver histology. Renal histology was graded for the presence of vacuoles as absent (0), scanty (1), or easily identifiable (2). Liver histology was graded for steatosis and for fibrosis if Masson trichrome staining was available. Vacuoles were commonly seen in the deaths of those with AUD. They were seen in deaths due to AKA but were not specific to that cause of death. With vacuoles present, lower vitreous sodium (139 vs. 142 mmol/L; p = 0.005), higher vitreous BHB (1.50 vs. 1.39 mmol/L; p = 0.04), severe hepatic steatosis, and severe hepatic fibrosis were seen, compared with those without renal vacuoles.

show abstract

“… 15 Specifically, hypotonicity can stimulate these channels, 40–42 resulting in increased endothelial calcium influx and pulmonary vascular permeability. 15 Therefore, hyponatremia can lead to pulmonary edema 43 , 44 and pleural effusion, 28 which further aggravates COPD. Hypernatremia in ICU is an iatrogenic problem due to excessive use of hypertonic solution and inadequate water substitution.…”

Section: Discussionmentioning

confidence: 99%

Association Between Serum Sodium and Long-Term Mortality in Critically Ill Patients with Comorbid Chronic Obstructive Pulmonary Disease: Analysis from the MIMIC-IV Database

Fan¹,

Sun²,

Jia³

et al. 2022

COPD

View full text Add to dashboard Cite

Purpose The purpose of our study was to investigate the relationship between serum sodium levels and 1-year and 3-year mortality in critically ill patients with comorbid chronic obstructive pulmonary disease using real-world data. Methods The data of this study were collected from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. First of all, we used the Kaplan–Meier curves and multivariable Cox regression analyses to measure the relationship between serum sodium levels and 1-year and 3-year mortality for critically ill patients with comorbid COPD. Next, a restricted cubic spline was used to analyze non-parametrically the relationship between mortality and serum sodium as a continuous variable. In addition, we also analyzed the mortality of different subgroups. Results A total of 5540 eligible subjects were extracted. Compared to normal serum sodium levels, adjusted multivariable Cox regression analysis confirmed that hyponatremia and hypernatremia were still significantly associated with 1-year mortality (HR = 1.551, 95% CI = 1.333~1.805, P<0.001; HR = 1.683, 95% CI = 1.317~2.151, P<0.001, respectively) and 3-year mortality (HR = 1.507, 95% CI = 1.302~1.744, P<0.001; HR = 1.612, 95% CI = 1.269~2.048, P<0.001, respectively). In patients with or without adjustment variables, there was an obvious U-shaped non-linear relationship between serum sodium levels and 1-year and 3-year mortality with a reference level of 139 mmol/L, which indicated that patients in both hyponatremia and hypernatremia had higher mortality than normal serum sodium levels. Conclusion This study showed that both hyponatremia and hypernatremia were related to increased 1-year and 3-year mortality in critically ill patients with comorbid COPD, which provides a new reference for the control strategy of correcting serum sodium levels.

show abstract

Postmortem diagnosis of hyponatremia: case report and literature review

Cited by 9 publications

References 79 publications

Health Impacts and Recovery From Prolonged Freshwater Exposure in a Common Bottlenose Dolphin (Tursiops truncatus)

Health Impacts and Recovery From Prolonged Freshwater Exposure in a Common Bottlenose Dolphin (Tursiops truncatus)

Subnuclear renal tubular vacuoles in alcohol use disorder

Association Between Serum Sodium and Long-Term Mortality in Critically Ill Patients with Comorbid Chronic Obstructive Pulmonary Disease: Analysis from the MIMIC-IV Database

Contact Info

Product

Resources

About