Chromoganin A (CgA) is widely distributed in the secretory granules of endocrine and neuroendocrine cells and cosecreted with
hormones such as
catecholamines. The present study investigated postmortem serum and cerebrospinal fluid (CSF) levels of CgA in comparison with those of
catecholamines, and also cellular CgA immunopositivity in the hypothalamus, adenohypophysis and adrenal medulla to assess forensic pathological significance. Serial medicolegal autopsy cases (n = 298, within 3 days postmortem) were used. Serum and CSF CgA levels were independent of the gender or age of subjects or postmortem time. The most characteristic findings were seen for fatal
hypothermia (cold exposure),
hyperthermia (
heat stroke) and intoxication. Serum CgA levels were lower for
hypothermia and intoxication than for other causes of death (p < 0.05), while CSF CgA levels were higher for
hypothermia (p < 0.0001). A negative correlation was detected between serum and CSF CgA levels for
hypothermia (R = 0.552, p < 0.05). Correlations between serum levels of CgA and
catecholamines (
adrenaline,
noradrenaline and
dopamine) were evident for
hyperthermia (R = 0.632-0.757, p < 0.05 to <0.01), but there was no significant correlation between CgA and
catecholamine levels in CSF. Cellular CgA immunopositivity in the hypothalamus, adenohypophysis and adrenal medulla varied extensively among cases in each group. However, CgA immunopositivity in hypothalamus neurons was lower for
hypothermia than other causes of death including
hyperthermia and intoxication. These observations suggest characteristic neuroendocrinal activation in fatal cases of hypo- and
hyperthermia and also intoxication. CgA may be a useful biochemical and immunohistochemical marker for investigating these causes of death.