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Postmortem diagnosis of hypothermia

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Abstract

The identification of hypothermia as the cause of death has always been somewhat problematic in forensic pathology because of unspecific, inconstant, or even negative macroscopic and microscopic findings. Though the simultaneous presence of frost erythema, Wischnewski spots, hemorrhages into the synovial membrane, bloody discoloration of synovial fluid of the knee, and basal vacuolization of the renal tubular epithelial cells has been indicated as strongly supportive of fatal hypothermia, their absence does not allow the diagnosis of hypothermia to be ruled out. Postmortem biochemical investigations are valuable in detecting adaptation responses to cold stress and metabolic changes that occur following cold exposure. However, ethanol intoxication prevents appearance of adaptation responses to cold, rendering the diagnosis less obvious. Immunohistochemistry, postmortem imaging, and molecular pathology have shown promising results, although at present, they do not provide pathognomonic signs of fatal hypothermia. The aim of this article is to present a review of the literature covering the significance of different postmortem investigations that are associated with hypothermia fatalities.

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Acknowledgments

The authors are grateful to the anonymous reviewers whose constructive and useful comments improved the quality of the article.

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Authors and Affiliations

  1. University Centre of Legal Medicine, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland

    Cristian Palmiere

  2. Department of Forensic Medicine, Medical University of Lublin, Lublin, Poland

    Grzegorz Teresiński

  3. Department of Forensic Medicine, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Králové, Sokolská 581, 500 05, Hradec Králové, Czech Republic

    Petr Hejna

Authors
  1. Cristian Palmiere
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  2. Grzegorz Teresiński
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  3. Petr Hejna
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Correspondence to Cristian Palmiere.

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Palmiere, C., Teresiński, G. & Hejna, P. Postmortem diagnosis of hypothermia. Int J Legal Med 128, 607–614 (2014). https://doi.org/10.1007/s00414-014-0977-1

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