由于过量服用胰岛素而被诊断为低血糖脑病变的组织病理学诊断病例
Hitomi Umemoto1,2, Hideyuki Nushida1, Asuka Ito1
1Department of Forensic Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
一名70岁的老人死于低血糖脑病变. 尸检分析证实了胰岛素过量服用,在注射部位检测到胰岛素,以及与严重低血糖相一致的脑部变化.
科学领域:
- 法医病理学 法医病理学
- 毒理学 毒理学 毒理学
- 神经病理学神经病理学
背景情况:
- 一名70岁的男性患有糖尿病,高血压,中风和抑郁症的病史.
- 患者在长时间睡眠后被发现无反应,导致在医院宣布死亡.
研究的目的:
- 为了确定死因,一个病例呈现出心肺骤停和疑似过量服用.
- 评估组织学检查在死后诊断胰岛素过量剂量的实用性.
主要方法:
- 死后血液检查胰岛素,C和葡萄糖水平.
- 尸体解剖,并对注射部位进行详细检查.
- 使用抗胰岛素和抗GFAP抗体对皮肤和大脑组织进行组织病理学和免疫组织化学分析.
主要成果:
- 死亡后血糖非常低 (9 mg/dL),可检测胰岛素 (0.54 μU/mL) 和低C (0.14 ng/mL).
- 尸检显示注射部位出血;免疫组织化学证实了皮下组织,周血管区域和神经元中胰岛素的存在.
- 大脑组织学显示轻度胀和类型腺,与低血糖脑病变相一致.
结论:
- 死亡原因被确定为胰岛素过量后的低血糖脑病变.
- 组织学检查,特别是免疫组织化学检查,在验尸诊断中证实胰岛素过量服用是有价值的.
- 这一案例凸显了在疑似毒理性死亡事件中进行全面的死后分析的重要性.
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