Acute,massive, haemorrhagic adrenal necrosis experimentally produced by the Shwartzman mechanism in rabbits |
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Authors: | Hiromu Aoyama Fumihito Kikuchi Wataru Mori |
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Institution: | (1) Department of Pathology, Faculty of Medicine, University of Tokyo, Tokyo, Japan |
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Abstract: | Summary Acute and severe haemorrhagic necrosis of the adrenal was produced experimentally in rabbits by means of intravenous injection of endotoxin after pretreatment by adrenocorticotropic hormone (ACTH) administration. The change occurred mainly in thezona fasciculata of the adrenal cortex, and its pathology was quite similar to that of the Shwartzman reaction. Numerous microthrombi were found in and around the lesion, but no marked changes were seen in other parts of the body. Heparin administration was very effective in preventing the necrosis. The pathogenesis of this lesion was postulated to be a univisceral Shwartzman mechanism in the adrenal. This seems to be a good experimental model for massive haemorrhagic necrosis of the adrenal in man, for example in the Waterhouse-Friderichsen syndrome, the pathogenesis of which has been assumed to involve intravascular clotting. It is suggested that hyperfunction of the adrenal cortex caused by ACTH administration could be a preparative condition for the Shwartzman reaction.This study was supported in part by a grant-in-aid from the Japanese Ministry of Education, Science and Culture |
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Keywords: | Adrenal haemorrhagic necrosis Univisceral Shwartzman reaction Waterhouse-Friderichsen syndrome Preparative condition of Shwartzman reaction Disseminated intravascular coagulation |
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