Korean J Leg Med.  2013 Nov;37(4):212-215. 10.7580/kjlm.2013.37.4.212.

Cheese-like Material in the Heart: An Autopsy Case Report of Severe Hypertriglyceridemia in Diabetic Ketoacidosis Patient

  • 1Forensic Medicine Division, National Forensic Service, Seoul, Kore. pdrdream@gmail.com
  • 2Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea.


Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.


Diabetic ketoacidosis; Severe hypertriglyceridemia; Creamy blood; Autopsy

MeSH Terms

Diabetic Ketoacidosis*
Postmortem Changes


  • Fig. 1. A lump of cheese-like material was noted in the heart, when inferior vena cava was cut (fig. 1a) and when the heart was incised (fig. 1b).

  • Fig. 2. A creamy plasma was noted in the post-centrifugal peripheral blood.

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