The Shwartzman Phenomenon

2015 ◽  
pp. 128-133
Author(s):  
Jay L. Rothstein ◽  
Hans Schreiber
Keyword(s):  
Shwartzman Phenomenon

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.

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.

The shwartzman phenomenon complicating acute meningococcemia with meningitis

1951 ◽  
Vol 38 (3) ◽  
pp. 369-374 ◽  
Author(s):  
S. David Sternberg ◽  
Ben M. Zweifler ◽  
Seymour Gruber ◽  
Jacob Lichterman
Keyword(s):  
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.

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