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Journal Article

Citation

Tong F, Wu R, Huang W, Yang Y, Zhang L, Zhang B, Chen X, Tang X, Zhou Y. Forensic Sci. Int. 2017; 278: 9-15.

Affiliation

Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, PR China. Electronic address: zhouyiwu@outlook.com.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.forsciint.2017.06.015

PMID

28686962

Abstract

Analysis of homicidal insulin overdose is a challenging task in forensic practice because of the difficulties in toxicological analysis as well as the elusive pathologic changes. We performed a detailed histopathologic examination on four autopsy cases involving insulin homicide, using H&E, immunohistochemistry (IHC) and immunofluorescence assays. Severe reactive astrocyte proliferation was obvious in the white matter of the cerebrum, corpus callosum, cerebellum and brain stem, especially in subcortical regions. We found a statistically significant increase in the number and total area of reactive astrocytes compared with controls (p<0.001). Insulin was detected at the injection sites of subcutaneous soft tissues by using IHC, luminescence immunoassay and immunofluorescence. Most insulin deposits were located in the gaps between adipocytes, and a few deposits were located in peripheral nerves and inflammatory cells. We also detected protamine in the skin tissues in two of the four cases. Our study revealed that the presence of insulin and/or protamine at the injection sites, along with severe reactive astrocyte proliferation, could help diagnose insulin overdose.

Copyright © 2017 Elsevier B.V. All rights reserved.


Language: en

Keywords

Forensic pathology; GFAP; Homicide; Immunohistochemistry; Insulin overdose; Protamine

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