Evaluation post-mortem du statut nutritionnel chez un nourrisson par dosage des marqueurs biochimiques dans le sang et le serum et criblage des oligo-elements dans les cheveux

摘要

The aim of this article is to present two complementary approaches, one based on biochemical investigation and the other on the testing of trace elements in hair, in order to explore the nutritional status of children for whom denutrition is suspected at autopsy. A 9-months-old girl was found dead at home. The corpse was transferred to a specialized hospital unit in sudden infant death syndrome at DO. As the first examination showed ecchymosis, an inquiry has been opened. Autopsy was done (D1) and revealed a traumatic brain injury, cause of death, and a severe growth retardation. In this context, the magistrate ordered, in addition to toxicological investigations, to carry out any analysis to evaluate the nutritional status of the child. Analyses were performed in a serum sample obtained at DO and in peripheral blood and hair sampled during the autopsy. All the toxicological investigations were negative. Biochemical analyses showed an increase of uric acid, while albumin, pre-albumin, urea, creatinine and (3-hydroxybutyrate concentrations were within the normal range. The testing for trace elements by ICP-MS showed concentrations comparable to those measured in healthy subjects and in children from the same age group. The pathological examination does not show any lesion in favor of a denutrition. In conclusion, these two complementary approches allowed to rule out a starvation. Although little exploited in this indication,' the testing for trace elements in hair could be useful, especially to increase the detection window or when the samples required for biochemical analyzes are not available. Further case studies are needed to support this hypothesis.