Comparison of C-reactive protein levels between antemortem serum and postmortem serum and pericardial fluid

Biochemical markers undergo postmortem changes that complicate diagnostic measurement. C-reactive protein (CRP) is one marker that is known to be useful in postmortem specimens, with high levels reported in forensic cases of sepsis, trauma, and ketoacidosis. In the present study, we included 30 cases (17 males and 13 females) that underwent forensic autopsy within 80 h of death and had a CRP result from two postmortem specimens (serum from cardiac blood and pericardial fluid) and an emergency room specimen. Antemortem results were taken at a time near to cardiopulmonary arrest and the declaration of death. CRP levels in postmortem serum and pericardial fluid correlated with those in antemortem serum. Although no significant difference was observed between the antemortem and postmortem serum levels, the pericardial level was significantly low and five false negatives were observed. We conclude that postmortem serum is suitable for use in CRP measurement, and in cases with high antemortem CRP levels, postmortem pericardial fluid may be an appropriate alternative.