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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Astrup, T., Buluk, K.: Thromboplastic and fibrinolytic activities in vessels of animals. Circulat. Res. 13, 253–260 (1963)
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)
Baiton, D.F.: Sequential degranulation of the two types of polymorphonuclear leukocyte granules during phagocytosis of microorganisms. J. Cell Biol. 58, 249–264 (1973)
Baumgartner, H.R.: The subendothelial surface and thrombosis. Thrombos. Diathes. Haemorrh., Suppl. 59, 91–105 (1974)
Bohle, A., Sitte, H., Miller, F.: Elektronenmikroskopische Untersuchungen am Glomerulum des Kaninchens beim generalisierten Shwartzman-PhÄnomen. Verh. dtsch. Ges. Path. 41, 326–332 (1958)
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)
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)
Hirsch, J.G., Cohn, Z.A.: Degranulation of polymorphonuclear leukocytes following phagocytosis of microorganisms. J. exp. Med. 112, 1005–1014 (1960)
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)
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)
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)
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 1973
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)
Margaretten, W., McKay, D.G.: The role of the platelet in the generalized Shwartzman reaction. J. exp. Med. 129, 585–590 (1969)
McGrath, J.M., Stewart, G.J.: The effects of endotoxin on vascular endothelium. J. exp. Med. 129, 833–848 (1969)
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 1973
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)
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)
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)
Mustard, J.F., Packham, M.A.: Platelet aggregation and the platelet release reaction in thromboembolism. Canad. med. Ass. J. 103, 859–863 (1970)
Niemetz, J.: Coagulant activity of leukocytes. Tissue factor activity. J. clin. Invest. 51, 307–313 (1972)
Niemetz, J., Fani, K.: Thrombogenic activity of leukocytes. Blood 42, 47–59 (1973)
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)
Riddle, J.M., Barnhart, M.I.: Ultrastructural study of fibrin dissolution via emigrated polymorphonuclear neutrophils. Amer. J. Path. 45, 805–823 (1964)
Shigematsu, H.: Glomerular events during the initial phase of rat Masugi nephritis. Virchows Arch. Abt. B 5, 187–200 (1970)
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)
Spaet, T.H.: Vascular lesions: Possible pathogenetic basis of the generalized Shwartzman reaction. Science 170, 986–988 (1970)
Stemerman, M.B., Baumgartner, H.R., Spaet, T.H.: The subendothelial microfibril and platelet adhesion. Lab. Invest. 24, 179–186 (1971)
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)
Suzuki, Y., Churg, J., Grishman, E., Mautner, W., Dachs, S.: The mesangium of the renal glomerulus. Amer. J. Path. 43, 555–578 (1963)
Thomas, L., Good, R.A.: Studies on the generalized Shwartzman reaction: I. General observations concerning the phenomenon. J. exp. Med. 96, 605–624 (1952)
Vassalli, P., McCluskey, R.T.: The pathogenic role of the coagulation process in rabbit Masugi nephritis. Amer. J. Path. 45, 653–677 (1964)
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)
Watanabe, T.: Coagulative properties of arterial wall and arteriosclerosis. Fukuoka Acta Med. 61, 682–694 (1970)
Watanabe, T., Arihiro, H.: The role of fibrin in glomerulonephritis. Jap. J. Nephrol. 17, 262–273 (1975)
Watanabe, T., Tanaka, K.: The role of coagulation and fibrinolysis in the development of rabbit Masugi nephritis. Acta path. jap. 26, 147–165 (1976)
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)
Author information
Authors and Affiliations
Additional information
Supported in part by grants from the Japanese Ministry of Education
Rights and permissions
About this article
Cite this article
Watanabe, T., Tanaka, K. Electron microscopic observations of the kidney in the generalized Shwartzman reaction. Virchows Arch. A Path. Anat. and Histol. 374, 183–196 (1977). https://doi.org/10.1007/BF00427113
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00427113