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. 1977;18(4):522-31.
doi: 10.1186/BF03548416.

The sequence of events in the development of bilateral renal cortical necrosis accompanying the generalized Shwartzman reaction

K Nordstoga

The sequence of events in the development of bilateral renal cortical necrosis accompanying the generalized Shwartzman reaction

K Nordstoga. Acta Vet Scand. 1977.

Abstract
in English, German

The generalized Shwartzman reaction, or Shwartzman-like conditions, were induced in a variety of experimental mammalian species by systemic injections of disintegrated cells of Gram negative bacteria, live Salmonella cholerae-suis or Liquoid. A comparative study of the renal lesions showed that the initial step in the development of bilateral cortical necrosis is stagnation and disintegration of red cells in glomerular capillaries. The glomerular “microthrombi” consist mainly of erythrocytic debris, which frequently has staining properties akin to those of fibrin; even wide-spread glomerular “thrombosis” is not accompanied by obvious destruction of renal parenchyma. A second step is necrotic mural lesions in afferent arteries, with ensuing thrombosis. These vascular lesions lead to the formation of individual infarcts which fuse to form total bilateral cortical necrosis in fulminant cases of the generalized Shwartzman reaction.

Generalisert Shwartzman’s reaksjon, eller Shwartzman’s lignende tilstander, ble framkalt hos en rekke arter av pattedyr ved injeksjon av disintegrerte Gram negative bakterier, levende Salmonella choleraesuis, eller Liquoid. En komparativ studie av nyreskaden viste at de først registrerbare forandringer i glomeruli er stase og disintegrering av røde blodlegemer i kapillærene i glomeruli. „Mikrotrombene“ i glomeruli består vesentlig av henfallende erytrocytter; dette materialet har ofte samme fargeegenskaper som fibrin. Selv uttalte „tromboseringer“ i glomeruli er ikke ledsaget av tydelige makroskopiske henfallsprosesser i nyreparenchymet. Et neste skritt er utvikling av nekrotiserende forandringer i veggen av afferente arterier; disse karveggsforandringene er ofte ledsaget av tromboseringer. Karforandringene fører til dannelse av infarkter som så flyter sammen og gir total nyrebarknekrose i fulminante tilfeller av den generaliserte Shwartzman’s reaksjon.

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