Volume 45, Issue 3 (May 2000)

    Beta-Hydroxybutyric Acid—An Indicator for an Alcoholic Ketoacidosis as Cause of Death in Deceased Alcohol Abusers

    (Received 11 March 1999; accepted 13 August 1999)

    CODEN: JFSOAD

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    Abstract

    We analyzed the postmortem blood of a total of 100 fatal cases for beta-hydroxybutyric acid (BHBA). In 25 cases of sudden and unexpected death of alcoholics we found pathologically increased levels of BHBA of 1260 to 47 200 (median 8000) µmol/L. This led us to the diagnosis of an alcoholic ketoacidosis (AKA) as cause of death in these cases. The control group of 69 postmortem cases revealed that BHBA concentrations below 500 can be regarded as normal, and values up to 2500 µmol/L as elevated. Our study shows that BHBA values over 2500 µmol/L could lead to death, if no medical attention is sought. During storage we did not find any indication of postmortem formation or decomposition of BHBA in blood in vitro or in the corpses. In our opinion, BHBA should be considered the diagnostic marker of choice for the postmortem determination of alcoholic ketoacidosis (AKA) as the cause of death. The classical indications of such deaths are: unexpected death of a chronic alcoholic; none or only traces of ethanol in the blood; increased acetone blood concentration; and neither autopsy, histology, microbiology, nor toxicology reveal the cause of death. In six further cases a diabetic ketoacidosis (DKA) was diagnosed as the cause of death.


    Author Information:

    Meier, M
    Institute of Forensic Medicine, University of Zurich, Zurich,

    Iten, PX
    Institute of Forensic Medicine, University of Zurich, Zurich,


    Stock #: JFS14739J

    ISSN: 0022-1198

    DOI: 10.1520/JFS14739J

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    Author
    Title Beta-Hydroxybutyric Acid—An Indicator for an Alcoholic Ketoacidosis as Cause of Death in Deceased Alcohol Abusers
    Symposium , 0000-00-00
    Committee E30