Increased urinary concentration of catecholamines in hypothermia deaths

Observations are presented on 24 hypothermia deaths, either accidental or suicidal. Most cases occurred in dry, cold circumstances, the air temperature being below 0 degree C. More cases were seen in early winter, suggesting a lack of acclimatization to the cold. Purple skin and swelling of the ears and nose (mild frostbite) were the most frequent external signs of exposure. Frequent internal signs were stomach ulcerations or hemorrhagic gastritis and small degenerative foci in the myocardium. High blood alcohol (about 200 mg/dL) was the most common contributory factor, but psychotropic drugs were detected in a few cases. The total urinary catecholamine content was increased in the hypothermia deaths, with levels of 0.20 +/- 0.16 microgram/mL (mean +/- standard deviation) versus 0.07 +/- 0.07 microgram/mL in sudden natural deaths and 0.02 +/- 0.02 microgram/mL in rapid violent deaths. Adrenaline was more abundant than noradrenaline. It is suggested that urine catecholamine measurements can give useful information for the diagnosis of acute hypothermia.