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Catecholamines in urine after death
W P Tormey1, M Carney, R J FitzGerald
1Department of Chemical Pathology, Beaumont Hospital, Dublin, Ireland.
Insights
This study measured catecholamine levels in autopsy urine, finding elevated noradrenaline and adrenaline in most cases. These stress markers showed no significant difference between myocardial infarction and trauma deaths.
Area of Science:
- Forensic Medicine
- Clinical Chemistry
- Toxicology
Background:
- Catecholamine levels in urine can indicate physiological stress.
- Autopsy studies provide insights into post-mortem biochemical changes.
Purpose of the Study:
- To measure noradrenaline, adrenaline, and dopamine levels in autopsy urine.
- To compare these levels with essential hypertension reference values.
- To investigate differences in catecholamine levels between causes of death.
Main Methods:
- Analysis of 30 unselected autopsy urine specimens.
- High-performance liquid chromatography (HPLC) with electrochemical detection.
- Measurement of catecholamines relative to urine creatinine.
Main Results:
- Elevated noradrenaline (76.6%), adrenaline (80%), and dopamine (23.3%) were observed compared to hypertension reference values.
- No significant difference in median noradrenaline or adrenaline levels between myocardial infarction and trauma deaths.
- Autopsy noradrenaline values overlapped with normal subjects and phaeochromocytoma cases.
Conclusions:
- Autopsy urine catecholamine levels are frequently elevated, suggesting physiological stress prior to death.
- Myocardial infarction and severe trauma do not show distinct post-mortem urine catecholamine profiles.
- Further research is needed to interpret these findings in relation to specific pathologies.
Abstract:
Noradrenaline, adrenaline and dopamine levels were measured using high-performance liquid chromatography (HPLC) and electrochemical detection and related to urine creatinine in 30 specimens from unselected autopsies. Values calculated from patients with essential hypertension were used as a reference and raised values of noradrenaline, adrenaline and dopamine were found in 76.6, 80 and 23.3%, respectively. Using the Mann-Whitney U test, there was no difference between the 11 patients with myocardial infarction and the seven who died from severe head injury or multiple trauma. The median values in mmol/mol creatinine for patients with myocardial infarction and trauma were 0.07 and 0.12 for noradrenaline and 0.012 and 0.024 for adrenaline, respectively. Physiological stress is common before death and urine noradrenaline values at autopsy overlap those found in some normal subjects and at autopsy in patients with phaeochromocytoma.