Postmortem urinary catecholamine levels with regard to the cause of death.

Abstract

Previous studies suggested that serum catecholamines are useful for investigating stress responses in the death process. The present study analyzed postmortem urinary adrenaline (Ad), noradrenaline (Nad) and dopamine (DA) in serial forensic autopsy cases (n=199: 154 males and 45 females; age >9years; survival time <0.5-168h; within 10days postmortem) to investigate the differences among the causes of death with special regard to hyperthermia (heatstroke; n=11) and hypothermia (cold exposure; n=10); other cases included fatalities from injury (n=47), mechanical asphyxiation (n=18), drowning (n=14), intoxication (n=31), fire fatality (n=33) and natural death (n=35). Each catecholamine level in urine was independent of the age or gender of the subjects, postmortem interval over 10days or survival time, and did not correlate with the blood level. Urinary Adr and Nad levels were similar to those of clinical serum reference ranges, while DA was higher in all cases. Adr and Nad were higher in blunt head injury, methamphetamine abuse, hypothermia (cold exposure) and hyperthermia (heat stroke), but were low in mechanical asphyxia, drowning, fire fatality, sedative-hypnotic intoxication and acute cardiac death. DA was higher in injury, drowning, fire fatality, methamphetamine abuse and acute cardiac death, but was lower in mechanical asphyxiation and sedative-hypnotic intoxication. These profiles were quite different from those of serum levels, involving a predominant increase of DA, and may be useful for differentiating hyperthermia (heatstroke) and hypothermia (cold exposure) from drowning, sedative-hypnotic intoxication and sudden cardiac death.