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Virchows Archiv A

, Volume 374, Issue 3, pp 183–196 | Cite as

Electron microscopic observations of the kidney in the generalized Shwartzman reaction

  • Teruo Watanabe
  • Kenzo Tanaka
Article

Summary

Sequential changes in the kidney during the generalized Shwartzman reaction were studied electron microscopically. The first anatomical change was infiltration of neutrophils into the glomerular capillaries. Endothelial damage was not noticeable until the capillaries were filled with fibrin deposits. Fibrin appeared in the mesangium at almost the same time as in the capillary lumina, traversing through the endothelial fenestrae. Endothelial damage was more common in the mesangial portion than in the peripheral portion of the capillaries. Severe mesangiolysis developed after loss of endothelial cells had been followed by massive penetration of intracapillary contents. Later, signs of repair were evident in some parts of the damaged endothelium. The development of cortical necrosis coincided with the appearance of mesangiolysis and arteriolar thrombotic lesions.

Key Words

Endotoxin Intravascular coagulation Glomerular ultrastructure Mesangiolysis Renal cortical necrosis 

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References

  1. Astrup, T., Buluk, K.: Thromboplastic and fibrinolytic activities in vessels of animals. Circulat. Res. 13, 253–260 (1963)Google Scholar
  2. Baggiolini, M., Hirsch, J.G., de Duve, C.: Resolution of granules from rabbit heterophil leukocytes into distinct populations by zonal sedimentation. J. Cell Biol. 40, 529–541 (1969)Google Scholar
  3. Baiton, D.F.: Sequential degranulation of the two types of polymorphonuclear leukocyte granules during phagocytosis of microorganisms. J. Cell Biol. 58, 249–264 (1973)Google Scholar
  4. Baumgartner, H.R.: The subendothelial surface and thrombosis. Thrombos. Diathes. Haemorrh., Suppl. 59, 91–105 (1974)Google Scholar
  5. Bohle, A., Sitte, H., Miller, F.: Elektronenmikroskopische Untersuchungen am Glomerulum des Kaninchens beim generalisierten Shwartzman-PhÄnomen. Verh. dtsch. Ges. Path. 41, 326–332 (1958)Google Scholar
  6. Cohn, Z.A., Hirsch, J.G.: The isolation and properties of the specific cytoplasmic granules of rabbit polymorphonuclear leukocytes. J. exp. Med. 112, 983–1004 (1960)Google Scholar
  7. Evans, G., Mustard, J.F.: Inhibition of the platelet surface reaction in endotoxin shock and the generalized Shwartzman reaction. J. clin. Invest. 47, 31 a (1968)Google Scholar
  8. Hirsch, J.G., Cohn, Z.A.: Degranulation of polymorphonuclear leukocytes following phagocytosis of microorganisms. J. exp. Med. 112, 1005–1014 (1960)Google Scholar
  9. Horn, R.G., Collins, R.D.: Studies on the pathogenesis of the generalized Shwartzman reaction. The role of granulocytes. Lab. Invest. 18, 101–107 (1968a)Google Scholar
  10. Horn, R.G., Collins, R.D.: Fragmentation of granulocytes in pulmonary capillaries during development of the generalized Shwartzman reaction. Lab. Invest. 19, 451–459 (1968b)Google Scholar
  11. Kawaji, K., Ôyama, M.: Electron microscopic study of renal lesion of rabbit caused by toxicosis of “Habu” venom. Acta Med. Univ. Kagoshima 3, 133–149 (1960)Google Scholar
  12. Kincaid-Smith, P.: The role of coagulation in the obliteration of glomerular capillaries. In: Glomerulonephritis, ed. by Kincaid-Smith, P., Mathew, T.H., and Becker, R.L., pp. 871–890. New York: John Wiley and Sons 1973Google Scholar
  13. Kondo, T., Shigematsu, H., Kobayashi, Y.: Cellular aspects of rabbit Masugi nephritis. II. Progressive glomerular injuries with crescent formation. Lab. Invest. 27, 620–631 (1972)Google Scholar
  14. Margaretten, W., McKay, D.G.: The role of the platelet in the generalized Shwartzman reaction. J. exp. Med. 129, 585–590 (1969)Google Scholar
  15. McGrath, J.M., Stewart, G.J.: The effects of endotoxin on vascular endothelium. J. exp. Med. 129, 833–848 (1969)Google Scholar
  16. McKay, D.G.: Blood coagulation and toxemia of pregnancy. In: Glomerulonephritis, ed. by Kincaid-Smith, P., Mathew, T.H., and Becker, E.L., pp. 963–995. New York: John Wiley and Sons 1973Google Scholar
  17. McKay, D.G., Latour, J.-G., Lopez, A.M.: Production of the generalized Shwartzman reaction by activated Hageman factor and α-adrenergic stimulation. Thrombos. Diathes. Haemorrh. 26, 71–76 (1971)Google Scholar
  18. McKay, D.G., Margaretten, W., Csavossy, I.: An electron microscope study of the effects of bacterial endotoxin on the blood-vascular system. Lab. Invest. 15, 1815–1829 (1966)Google Scholar
  19. Mustard, J.F., Kinlough-Rathbone, R.L., Packham, M.A.: Recent status of research in the pathogenesis of thrombosis. Thrombos. Diathes. Haemorrh., Suppl. 59, 157–188 (1974)Google Scholar
  20. Mustard, J.F., Packham, M.A.: Platelet aggregation and the platelet release reaction in thromboembolism. Canad. med. Ass. J. 103, 859–863 (1970)Google Scholar
  21. Niemetz, J.: Coagulant activity of leukocytes. Tissue factor activity. J. clin. Invest. 51, 307–313 (1972)Google Scholar
  22. Niemetz, J., Fani, K.: Thrombogenic activity of leukocytes. Blood 42, 47–59 (1973)Google Scholar
  23. Pappas, G.D., Ross, M.H., Thomas, L.: Studies on the generalized Shwartzman reaction. VIII. The appearance, by electron microscopy, of intravascular fibrinoid in the glomerular capillaries during the reaction. J. exp. Med. 107, 333–340 (1958)Google Scholar
  24. Riddle, J.M., Barnhart, M.I.: Ultrastructural study of fibrin dissolution via emigrated polymorphonuclear neutrophils. Amer. J. Path. 45, 805–823 (1964)Google Scholar
  25. Shigematsu, H.: Glomerular events during the initial phase of rat Masugi nephritis. Virchows Arch. Abt. B 5, 187–200 (1970)Google Scholar
  26. Shigematsu, H., Kobayashi, Y.: Accelerated serum sickness in rabbit. II. Glomerular ultrastructural lesions in transient proliferative and progressive disorganizing glomerulonephritis. Virchows Arch. Abt. A 369, 269–282 (1976)Google Scholar
  27. Spaet, T.H.: Vascular lesions: Possible pathogenetic basis of the generalized Shwartzman reaction. Science 170, 986–988 (1970)Google Scholar
  28. Stemerman, M.B., Baumgartner, H.R., Spaet, T.H.: The subendothelial microfibril and platelet adhesion. Lab. Invest. 24, 179–186 (1971)Google Scholar
  29. Stewart, G.J., Anderson, M.J.: An ultrastructural study of endotoxin induced damage in rabbit mesenteric arteries. Brit. J. exp. Path. 52, 75–80 (1971)Google Scholar
  30. Suzuki, Y., Churg, J., Grishman, E., Mautner, W., Dachs, S.: The mesangium of the renal glomerulus. Amer. J. Path. 43, 555–578 (1963)Google Scholar
  31. Thomas, L., Good, R.A.: Studies on the generalized Shwartzman reaction: I. General observations concerning the phenomenon. J. exp. Med. 96, 605–624 (1952)Google Scholar
  32. Vassalli, P., McCluskey, R.T.: The pathogenic role of the coagulation process in rabbit Masugi nephritis. Amer. J. Path. 45, 653–677 (1964)Google Scholar
  33. Vassalli, P., Morris, R.H., McCluskey, R.T.: The pathogenic role of fibrin deposition in the glomerular lesions of toxemia of pregnancy. J. exp. Med. 118, 467–478 (1963)Google Scholar
  34. Watanabe, T.: Coagulative properties of arterial wall and arteriosclerosis. Fukuoka Acta Med. 61, 682–694 (1970)Google Scholar
  35. Watanabe, T., Arihiro, H.: The role of fibrin in glomerulonephritis. Jap. J. Nephrol. 17, 262–273 (1975)Google Scholar
  36. Watanabe, T., Tanaka, K.: The role of coagulation and fibrinolysis in the development of rabbit Masugi nephritis. Acta path. jap. 26, 147–165 (1976)Google Scholar
  37. Zucker-Franklin, D., Hirsch, J.G.: Electron microscopic studies on the degranulation of rabbit peritoneal leukocytes during phagocytosis. J. exp. Med. 120, 569–576 (1964)Google Scholar

Copyright information

© Springer-Verlag 1977

Authors and Affiliations

  • Teruo Watanabe
    • 1
  • Kenzo Tanaka
    • 1
  1. 1.Department of Pathology, Faculty of MedicineKyushu UniversityFukuoka CityJapan

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