When a death apparently associated to sexual assault is instead a natural death due to idiopathic hypereosinophilic syndrome: The importance of gamma-hydroxybutyric acid analysis in vitreous humor

Emiliano Maresi, Maria Concetta Rotolo, Angelo Montana, Francesco Paolo Busardò, Simona Pichini, Angelo Montana, Francesca Portelli

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

We here report a case involving a 21-year-old female, found dead in a central square of a city in the south ofItaly. Initial evidences and circumstances were suggestive of a death associated with a sexual assault. Twoperipheral blood and two vitreous humor samples were collected for the purpose of gamma-hydroxybutyric acid(GHB) testing from the dead body at two different post-mortem intervals (PMIs): approximately 2 (t0) and 36 (t1)hours. The obtained results showed that, between t0 and t1, there was an increase of GHB concentrations inperipheral blood and vitreous humor of 66.3% and 8.1%, respectively.This case was the first evidence of GHB post mortem production in a dead body and not in vitro, showing thatvitreous humor is less affected than peripheral blood in GHB post-mortem production.The value detected at t1 in peripheral blood (53.4 µg/mL) exceeded the proposed cut-off and if interpretedalone would have led to erroneous conclusions. This was not the case of vitreous humor GHB, whose postmortem increase was minimal and it allowed to exclude a GHB exposure.Only after a broad forensic investigation including a complete autopsy, serological, histological, toxicologicaland haematology analyses, a diagnosis of idiopathic hypereosinophilic syndrome, a myeloproliferative disordercharacterized by persistent eosinophilia associated with damage to multiple organs, was made and the cause ofdeath was due to a pulmonary eosinophilic vasculitis responsible for an acute respiratory failure.
Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalLegal Medicine
Volume26
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Issues, ethics and legal aspects

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