Can Renal Acute Tubular Necrosis Be Differentiated from Autolysis at Autopsy?* |
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| Authors: | Linda Kocovski BSc Johan Duflou MMed FRCPA |
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| Institution: | 1. Central Clinical School, University of Sydney, Sydney, NSW 2006, Australia.;2. Central Clinical School, University of Sydney, Sydney, NSW 2006, Australia.
Department of Forensic Medicine, PO Box 90, Glebe NSW 2037, Australia. |
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| Abstract: | Abstract: We investigate the morphological characteristics that may differentiate between ischemic acute tubular necrosis (ATN) and autolysis in postmortem samples. Renal tissue from 57 postmortem cases with an antemortem diagnosis of ATN and 57 age-/sex-matched control cases were examined for 10 morphological characteristics: epithelial proliferation (Ki-67 immunoperoxidase positivity), fibrin thrombi, tubular epithelial whorls, mitoses, casts, autolysis, tubulorrhexis, epithelial flattening, interstitial inflammation, and interstitial expansion. Tubular epithelial whorls were found in 16 ATN cases and were absent in controls. These findings suggest that specific morphological criteria may distinguish ischemic ATN from autolysis. Diagnoses of ATN may be confirmed using these combined criteria as contributing to cause of death and/or to ascertain previously undiagnosed cases of ATN postmortem. |
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| Keywords: | forensic science renal acute tubular necrosis tubular epithelial whorl Ki-67 immunoperoxidase autopsy |
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