PMID: 16538014Mar 16, 2006Paper

An autopsy case of adrenal insufficiency 20 years after hypophysectomy: relation between stress and cause of death

The Journal of Medical Investigation : JMI
Shin-Ichi KuboOsamu Kitamura

Abstract

A 63-years-old man was found dead with the body soaking in water lying face up on a riverbank. Autopsy and diatom examination demonstrated that the cause of death was drowning. He had undergone hypophysectomy 20 years earlier. Autopsy, pathological and endocrinological findings demonstrated secondary and chronic hypothyroidism, hypogonadism, and adrenal insufficiency. The cadaver had fallen into the river, and received numerous wounds such as abrasions and subcutaneous hemorrhage. Moreover, it was suspected that he had developed hypothermia before death. Cortisol in the blood and 17- OHCS in urine were within the reference range. We suspect that the adrenocortical hormone was secreted into the blood as a result of various stresses due to wounds and hypothermia. However, it was suspected that sufficient hormone might not be secreted due to chronic adrenal insufficiency. This insufficient cortisol causes the decrease in the stress resistance, and might influence his cause of death. Moreover, as hypothyroidism decreases thermogenesis, he might have fallen into hypothermia easily. In addition, because both adrenocortical insufficiency and hypothyroidism caused the hypoglycemia, he might have fallen into the loss of consciousness. T...Continue Reading

References

Jun 1, 1993·The American Journal of Forensic Medicine and Pathology·J I Coe
Jun 1, 1997·The American Journal of Forensic Medicine and Pathology·S KuboI Nakasono
May 27, 2003·Reviews in Endocrine & Metabolic Disorders·Wouter W de Herder, Aart Jan van der Lely
Sep 15, 2004·Legal Medicine·Akiko IshigamiIchiro Nakasono

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Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.

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