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Biomarkers of Cerebral Damage in Fatal Hypothermia

Preliminary Results

Morleo, Bastien*; Teresinski, Gregor MD, PhD; Rousseau, Guillaume MD; Tse, Rexson BSc, MB, BS, FRCPA§; Tettamanti, Camilla MD; Augsburger, Marc PhD*; Palmiere, Cristian MD*

The American Journal of Forensic Medicine and Pathology: September 2019 - Volume 40 - Issue 3 - p 242–245
doi: 10.1097/PAF.0000000000000484
Original Articles

The identification of hypothermia as the cause of death remains challenging in forensic pathology because of unspecific radiological, morphological, and biochemical results. Hyperemia, edema, and petechial hemorrhages within the cerebral parenchyma were described in cases of death by hypothermia. On the other hand, the effect of low temperatures in the brain has been speculated to cause local injuries on a cellular level with potential occurrences of necrosis and inflammation. In the study herein described, endocan, alkaline phosphatase, neuron-specific enolase, S100 protein subunit B, glial fibrillary acidic protein, and C-reactive protein were measured in postmortem serum from femoral blood and cerebrospinal fluid in a series of hypothermia fatalities and control cases. The combination of data collected failed to identify a specific biochemical profile for death by hypothermia in postmortem serum and/or the cerebrospinal fluid, thus suggesting that an alternative panel of brain damage biomarkers indicative of diffuse hypoxic brain injury needs to be defined in hypothermia fatalities.

From the *CURML, Centre Universitaire Romand de Médecine Légale, Lausanne University Hospital, Lausanne, Switzerland

Department of Forensic Medicine, Medical University of Lublin, Lublin, Poland

Département de Biochimie et Génétique and Service de Médecine Légale et Pénitentiaire, Centre Hospitalier Universitaire D'Angers, Angers, France

§Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand

Departmental Section of Forensic and Legal Medicine and School of Specialization in Legal Medicine, University of Genova, Genova, Italy.

Manuscript received January 7, 2019; accepted March 1, 2019.

The authors report no conflict of interest.

Reprints: Bastien Morleo, CURML, Centre Universitaire Romand de Médecine Légale, Lausanne University Hospital, Chemin de La Vulliette 4, 1000 Lausanne, Switzerland. E-mail:

Online date: April 26, 2019

© 2019 by Lippincott Williams & Wilkins.