scholarly journals PLATELETS AND THE SHWARTZMAN PHENOMENON

1965 ◽  
Vol 121 (2) ◽  
pp. 235-246 ◽  
Author(s):  
Jack Levin ◽  
Leighton E. Cluff
Keyword(s):  
Intravenous Injection ◽  
Renal Lesions ◽  
Shwartzman Reaction ◽  
Hemorrhagic Lesion ◽  
Shwartzman Phenomenon

Studies are reported on the effect of immunologically induced thrombocytopenia upon the local and generalized Shwartzman phenomena. Intravenous injection of antiplatelet serum to rabbits produced profound but transient thrombocytopenia unaccompanied by significant changes in circulating leucocytes. Platelet antiserum alone given to rabbits prepared with thorotrast produced renal lesions characteristic of the Shwartzman reaction. Thrombocytopenia induced by platelet antiserum did not inhibit the cutaneous hemorrhagic lesion of the local Shwartzman phenomenon produced by sequential injections of endotoxin intracutaneously and intravenously. The implications of these observations in the pathogenesis of the local cutaneous and generalized Shwartzman reaction are discussed.

scholarly journals EXPERIMENTAL PRODUCTION OF HEMORRHAGE AND VASCULAR LESIONS IN LYMPH NODES: AN EXTENSION OF THE SHWARTZMAN PHENOMENON

1937 ◽  
Vol 65 (2) ◽  
pp. 287-302 ◽  
Author(s):  
Lewis Henry Koplik
Keyword(s):  
Lymph Nodes ◽  
Intravenous Injection ◽  
Lymphatic Drainage ◽  
Intradermal Injection ◽  
Vascular Lesions ◽  
Experimental Production ◽  
Intravenous Injections ◽  
Shwartzman Reaction ◽  
High Concentrations ◽  
Shwartzman Phenomenon

Characteristic changes are produced in the lymph nodes of rabbits following the intravenous injection of certain bacterial filtrates administered 24 hours after either an intralymphatic or an intradermal injection of the same filtrate. These changes are limited to the nodes served by the lymphatic injected or to those furnishing the lymphatic drainage for the injected skin site. By either method the initial or preparatory injection of filtrate reaches the lymph nodes through one or more of its afferent lymphatics, and similar lesions are produced in the nodes. The lesions consist of hemorrhages recognizable by gross and microscopic examination. The capillaries and veins are congested and thrombosed. Their endothelial cells are swollen. Arterioles are generally little affected. Though hemorrhages and thromboses are usually seen together in the nodes, they have been observed occurring independently. They are both probably secondary to endothelial changes. The lesions are not dependent on the amount of preexisting inflammation in the nodes. Endothelial changes, hemorrhages and thromboses were usually noted in the regional nodes when positive Shwartzman reactions had been elicited in prepared skin by intravenous injection of the bacterial filtrate. However, these lesions in many instances were observed under similar conditions in these nodes even when the Shwartzman reaction in the skin was negative. It appears that lymph nodes are more susceptible to the production of the Shwartzman phenomenon than the skin sites which they drain. A single intralymphatic or intradermal injection of the bacterial filtrates used in this study, even in high concentrations, does not produce in adjacent lymph nodes the characteristic changes noted when this preparatory injection is followed by a subsequent intravenous injection of the filtrate. Single intravenous injections also are not productive of hemorrhage and thrombosis in lymph nodes.

scholarly journals THE RELATION OF ALTERED LOCAL TISSUE REACTIVITY (SHWARTZMAN PHENOMENON) TO INFECTION AND INFLAMMATION

1937 ◽  
Vol 66 (5) ◽  
pp. 603-616
Author(s):  
Alan R. Moritz
Keyword(s):  
Intravenous Injection ◽  
Subcutaneous Injection ◽  
Local State ◽  
Local Tissue ◽  
Severe Inflammation ◽  
Infection And Inflammation ◽  
Shwartzman Reaction ◽  
Living Organisms ◽  
Shwartzman Phenomenon ◽  
Tissue Reactivity

Living B. aertrycke were effective in place of aertrycke filtrate as either the preparatory or the provocative injection in the production of a positive Shwartzman reaction. When living B. aertrycke were injected subcutaneously a more severe inflammation resulted, organization was delayed, and more living organisms survived at the site of inoculation in rabbits that had received 24 hours later an intravenous injection of B. aertrycke filtrate than was the case in similarly infected rabbits that had not received a subsequent injection of bacterial filtrate. When a local state of hypersusceptibility was created by the subcutaneous injection of B. aertrycke filtrate, the subsequent (24 hours) injection of living B. aertrycke led to the development at the site of subcutaneous preparation of a hemorrhagic necrosing inflammation in which the bacteria localized.

The Local Sanarelli-Shwartzman Phenomenon in Rats Induced by Human Leukaemic Cells

1973 ◽  
Vol 29 (02) ◽  
pp. 353-362
Author(s):  
J Lisiewicz ◽  
A Pituch ◽  
J. A Litwin
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Intravenous Injection ◽  
Peripheral Blood ◽  
Lymphocytic Leukaemia ◽  
Acute Myeloblastic Leukaemia ◽  
Demarcation Line ◽  
E Coli ◽  
Leukaemic Cells ◽  
Shwartzman Phenomenon

SummaryThe local Sanarelli-Shwartzman phenomenon (SSP-L) in the skin of 30 rats was induced by an intr a cutaneous sensitizing injection of leukaemic leucocytes isolated from the peripheral blood of patients with chronic lymphocytic leukaemia (CLL), acute myeloblastic leukaemia (AL) and chronic granulocytic leukaemia (CGL) and challenged by an intravenous injection of 100(μ of E. coli endotoxin. SSP-L was observed in 7 rats after injection of CLL lymphocytes and in 6 and 2 rats after AL myeloblasts and the CGL granulocytes, respectively. The lesions in the skin after AL myeloblasts appeared in a shorter time and were of longer duration compared with those observed after CLL lymphocytes and CGL granulocytes. Histologically, the lesions consisted of areas of destruction in the superficial layers of the skin ; the demarcation line showed the presence of neutrophils, macrophages and erythrocytes. Haemorrhages and fibrin deposits near the demarcation line were larger after injection of CLL lymphocytes and AL myeloblasts than after CGL granulocytes. The possible role of leucocyte procoagulative substances in the differences observed have been discussed.

Liquoid Induced Stasis and the Generalized Shwartzman Reaction

1979 ◽  
Vol 41 (04) ◽  
pp. 804-810 ◽  
Author(s):  
Knut Nordstoga
Keyword(s):  
Red Cells ◽  
Renal Lesions ◽  
Intravenous Injections ◽  
Shwartzman Reaction ◽  
Glomerular Capillaries

SummaryThe composition of the occlusive material within dilated glomerular capillaries, following intravenous injections of Liquoid in blue foxes, was studied electron microscopically; it was found that it mainly consisted of a debris in which disintegrated red cells constituted the major component. Damaged platelets and necrotic endothelial remnants were other components. These observations were interpreted as a result of glomerular stasis, and it was concluded that stasis in glomerular capillaries is a basic event in the development of the renal lesions accompanying the generalized Shwartzman reaction.

A Re-Appraisal of the Role of Blood Coagulation and Platelets in the Generalized Shwartzman Phenomenon

1966 ◽  
Vol 15 (03/04) ◽  
pp. 519-538 ◽  
Author(s):  
J Levin ◽  
E Beck
Keyword(s):  
Blood Coagulation ◽  
The State ◽  
Coagulation System ◽  
Renal Lesions ◽  
Intravascular Coagulation ◽  
Renal Glomeruli ◽  
Coagulation Mechanism ◽  
Shwartzman Phenomenon ◽  
Do So

SummaryThe role of intravascular coagulation in the production of the generalized Shwartzman phenomenon has been evaluated. The administration of endotoxin to animals prepared with Thorotrast results in activation of the coagulation mechanism with the resultant deposition of fibrinoid material in the renal glomeruli. Anticoagulation prevents alterations in the state of the coagulation system and inhibits development of the renal lesions. Platelets are not primarily involved. Platelet antiserum produces similar lesions in animals prepared with Thorotrast, but appears to do so in a manner which does not significantly involve intravascular coagulation.The production of adrenal cortical hemorrhage, comparable to that seen in the Waterhouse-Friderichsen syndrome, following the administration of endotoxin to animals that had previously received ACTH does not require intravascular coagulation and may not be a manifestation of the generalized Shwartzman phenomenon.

An Appraisal of Fulminant Meningococcemia with Reference to the Shwartzman Phenomenon

PEDIATRICS ◽  
1959 ◽  
Vol 23 (2) ◽  
pp. 341-341
Keyword(s):  
Steroid Therapy ◽  
Special Interest ◽  
Primary Lesion ◽  
Adrenal Steroids ◽  
Cortical Necrosis ◽  
Vascular Thrombosis ◽  
Adrenal Steroid ◽  
Shwartzman Reaction ◽  
Time Of Admission ◽  
Shwartzman Phenomenon

The object of this study was to evaluate the evidence for and against operation of the Shwartzman phenomenon (local or generalized) in meningococcemia. It is based on 52 cases of meningococcus infection seen at the Cincinnati Children's Hospital in a 20 year period. The fatal cases were compared with 152 patients who survived meningococcus infection. Vascular thrombosis appears to be the primary lesion involved in the production of the hemorrhagic lesions of the skin and adrenals in acute meningococcemia. It is suggested that these lesions may be produced by a local Shwartzman phenomenon. Of special interest is the occurrence of three instances of renal cortical necrosis, such as is seen characteristically in the generalized Shwartzman reaction. Because of the similarity of the lesions found in the fatal cases of meningococcus infection with the Shwartzman phenomenon, and the fact that cortisone is one of the most efficient methods of potentiating the Shwartzman phenomenon, led the authors to question the wisdom of the use of adrenal steroid therapy in fulminating meningococcus septicemia. It was also found that of 156 patients with meningococcus infection, not in shock at the time of admission, there was a mortality of 21% for the patients who received adrenal steroid therapy compared with a 7% mortality in those who did not receive adrenal steroids.

scholarly journals STRAIN DIFFERENCES IN LOCAL HEMORRHAGIC RESPONSE (SHWARTZMAN-LIKE REACTION) OF MICE TO A SINGLE INTRADERMAL INJECTION OF BACTERIAL POLYSACCHARIDES

1957 ◽  
Vol 105 (6) ◽  
pp. 653-664 ◽  
Author(s):  
Margaret G. Kelly ◽  
Norman H. Smith ◽  
Isidore Wodinsky ◽  
David P. Rall
Keyword(s):  
Strain Differences ◽  
Inbred Strains ◽  
Blocking Agent ◽  
Intradermal Injection ◽  
F1 Hybrid ◽  
Hemorrhagic Necrosis ◽  
Inbred Strains Of Mice ◽  
Anticoagulant Drug ◽  
Shwartzman Reaction ◽  
Hemorrhagic Lesion

A survey of inbred strains of mice was made to determine whether the phenomenon of dermal hemorrhagic necrosis, as described in rabbits by Shwartzman, could be elicited in mice by bacterial polysaccharide preparations of demonstrated activity in rabbits. The polysaccharide preparations used were obtained from cultures of S. marcescens, S. typhosa, Ps. aeruginosa, and H. pertussis. Ten of the strains tested were unreactive. Three strains of mice and one F1 hybrid subline developed a hemorrhagic lesion at the site of injection of a single, relatively high intradermal dose of polysaccharide. Some increase in incidence of hemorrhagic lesions was obtained when the intradermal dose was followed in 24 hours by an intravenous injection. In the gross and microscopically, the skin lesion produced in mice resembled the Shwartzman reaction in rabbits. An adrenergic blocking agent, SY-28, and an anticoagulant drug, coumadin, both of which block the dermal Shwartzman reaction in rabbits, also blocked the hemorrhagic skin reaction in mice.

scholarly journals STUDIES ON THE GENERALIZED SHWARTZMAN REACTION

1955 ◽  
Vol 102 (3) ◽  
pp. 249-261 ◽  
Author(s):  
Lewis Thomas ◽  
Joel Brunson ◽  
Richard T. Smith
Keyword(s):  
Polyvinyl Alcohol ◽  
Intravenous Injection ◽  
Dextran Sulfate ◽  
Nitrogen Mustard ◽  
Protective Action ◽  
Gram Negative ◽  
Single Intravenous Injection ◽  
Intravenous Injections ◽  
Shwartzman Reaction

Lesions indistinguishable from those of the generalized Shwartzman reaction occured in rabbits when a single intravenous injection of Gram-negative bacterial endotoxin was accompanied, or followed, by an injection of one of the following synthetic, heparin-like, acidic polymers-sodium polyanethol sulfonate, dextran sulfate, or sodium polyvinyl alcohol sulfonate. These reactions were produced by doses of polymer or of endotoxin which were without demonstrable effect when given singly. Heparin, in those similar to those previously shown to protect rabbits against the lesions of the generalized Shwartzman reaction, prevented the reaction to the combined injection of endotoxin and acidic polymers. Nitrogen mustard, which was previously shown to prevent the lesions of the generalized Shwartzman reaction from occurring after two intravenous injections of endotoxin, had no protective action against the lesions produced by the combined injection of endotoxin and polymer. Cortisone did not affect the reaction to endotoxin and polymer. The role of fibrinogen in the reaction under study is discussed in the paper which follows.

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