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Histological Changes in Adrenal Glands in Suicidal and Sudden Death Cases: A Postmortem Study
Sangita Chaurasia1, Anshuli Trivedi2, Ruchi Ganvir3
1Department of Forensic Medicine and Toxicology, Gandhi Medical College, Bhopal, IND.
Cureus
|March 25, 2024
Summary
Histological examination of adrenal glands revealed distinct changes in suicide victims due to chronic stress compared to acute stress. These findings, including lipid depletion and hemorrhage, help differentiate stress types in forensic investigations.
Area of Science:
- Forensic Pathology
- Endocrinology
- Psychiatry
Background:
- Chronic stress dysregulates the hypothalamic-pituitary-adrenal (HPA) axis, linked to suicidal behavior and affective disorders.
- Chronic stress can cause adrenal gland enlargement and functional alterations, potentially contributing to suicide in depressed individuals.
Purpose of the Study:
- To compare histological changes in adrenal glands between individuals who died by suicide (chronic stress) and those who died suddenly (acute stress).
Main Methods:
- Analytical study of 100 suicide cases and 20 sudden death controls.
- Histological examination of adrenal gland slides.
- Statistical analysis using GraphPad and Epi Info 7.
Main Results:
- Suicide cases showed significantly higher rates of capsular hemorrhage (98%), nodulation (48%), and specific zona fasciculata extension.
- Irregular zona glomerulosa thinning, shrunken cells, and increased nuclear density were specific to chronic stress in suicide victims.
- Diffuse lipid depletion (47%) and dilated sinusoids (98-99%) were prominent in suicide cases, unlike controls.
Conclusions:
- Histological changes like focal lipid depletion, hemorrhage, and nodular hyperplasia occur in acute stress but are less severe than in chronic stress associated with suicide.
- Specific adrenal gland alterations, including diffuse lipid depletion and dilated sinusoids, can help differentiate chronic stress from acute stress in forensic contexts.
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