Korean J Leg Med.  2016 Feb;40(1):8-13. 10.7580/kjlm.2016.40.1.8.

Study of the Test for Postmortem C-Reactive Protein in Routine Autopsy Practice

• Oh YH
• Ham SH
• Park JW
• Kim HS
• Park JT
• Na JY

• KMID: 2155724
• DOI: http://doi.org/10.7580/kjlm.2016.40.1.8

Abstract

C-Reactive protein (CRP) is an acute phase response protein synthesized in the liver as a response to various inflammation. CRP is extensively used as a general marker for inflammation in clinical medicine. A forensic applications of the CRP using postmortem samples have been studied in oversea. We have compared CRP in the between antemortem and postmortem samples and studied stability of postmortem blood samples for CRP test. In 69 consecutive autopsy cases, we have analysed heart blood samples (69 cases), peripheral blood samples (33 cases), and vitreous humor samples (60 cases). Postmortem CRP was elevated in 25 cases (36.2%) and possible causes of CRP elevation were inflammatory disease except one case (unknown). Postmortem CRP test shows sensitivity 86.7%, specificity 80%, positive predictive value 92.9%, and negative predictive value 66.7% for inflammation based on 20 cases with antemortem CRP results. The postmortem CRP levels were similar in the heart blood samples and peripheral blood samples. Vitreous humor samples are not useful in postmortem CRP testing. And both whole blood and serum samples are stable in room temperature until 31 days. We conclude that serum from heart blood is best suitable sample for postmortem CRP test and postmortem CRP test is useful in routine autopsy practice to detect inflammatory disease such as sepsis. From the view of postmortem point, we desire that this valuable test should be used in routine autopsy practice in Korea.

Keyword

Autopsy; C-Reactive protein; Forensic medicine

MeSH Terms

Autopsy*
C-Reactive Protein*
Clinical Medicine
Forensic Medicine
Heart
Inflammation
Korea
Liver
Sensitivity and Specificity
Sepsis
Vitreous Body
C-Reactive Protein

Figure

• 

  Fig. 1. (A) This graph shows postmortem C-reactive protein (CRP) level is decreased according to time of storage in positive result case. (B) This graph shows that the change of postmortem CRP is irregular in negative result case. (A, B) X indicates results of whole blood which was stored at room temperature; ▲ indicates results of whole blood which was kept refrigerated; ■ indicates results of serum which was stored at room temperature; ◆ indicates results of serum which was kept refrigerated.

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