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

Oh, Yeon Ho; Ham, Suk Hoon; Park, Jeong Woo; Kim, Hyung Seok; Park, Jong Tae; Na, Joo Young

doi:2016.40.1.8

Korean J Leg Med > Volume 40(1); 2016 > Article

Original article

Korean Journal of Legal Medicine 2016;40(1):8-13.
DOI: https://doi.org/10.7580/kjlm.2016.40.1.8 Published online February 29, 2016.

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

Yeon Ho Oh, Suk Hoon Ham, Jeong Woo Park, Hyung Seok Kim, Jong Tae Park, Joo Young Na

¹Forensic Medicine Division, National Forensic Service Gwangju Instititue, Jangseong, Korea. pdrdream@gmail.com
²Division of Forensic Medicine, National Forensic Service Busan Instititue, Yangsan, Korea.
³Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Korea.

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.

Key Words: Autopsy, C-Reactive protein, Forensic medicine