SUBNUCLEAR LIPID-CONTAINING VACUOLIZATION IN CASES OF KETOACIDOSIS - CORRELATION OF MORPHOLOGICAL FINDINGS AND KETONE BODY CONCENTRATIONS

J. Ulbricht, E. Doberentz, M. Krämer, B. Madea

Abstract: In cases of different causes of ketoacidosis, vacuole changes in the epithelium of the proximal renal tubules have been observed. Meanwhile it has been proven that subnuclear vacuolization is not only found in alcoholics but also in diabetic coma and fatal hypothermia. In this work, concentrations of the ketone body beta-hydroxybutyrate were determined and a histological examination of the kidneys was performed (HE-, PAS-, Sudan-staining). In a collective of 30 cases with alcohol abuse, fatal hypothermia, diabetes or combinations and 55 control cases, a strong correlation of the measured ketone body concentrations with subnuclear lipid-containing vacuolization in kidneys could be demonstrated. If the cause of death could not be clarified, this finding could be the reason for specific ketone body determinations to clarify the cause of death.
Keywords: ketoacidosis, kidney, Sudan staining, vacuolization, ketone body, diabetes, alcohol abuse, hypothermia