Necrotizing angiitis produced by the Shwartzman mechanism.

Abstract

Renal haemorrhagic and necrotic lesions, ranging from widespread haemorrhages to fulminant cortical necroses, were produced in experimental animals from 5 out of 9 mammalian species which received systemic injections of disintegrated cells of haemolytic Escherichia coli. In animals exhibiting obvious macroscopic kidney lesions, necrotic mural alterations were consistently found in interlobular arteries and often also in afferent glomerular arte‐rioles. The acute vascular damage was frequently characterized by fibrinoid necrosis of the vessel walls, and was inconstantly accompained by thrombosis and intramural and perivascular accumulations of inflammatory cells, predominantly eosinophils and mononuclear cells. The vascular injury was interpreted as a type of hypersensitivity angiitis, and indicates that hypersensitive mechanisms are operative in the generalized Shwartzman reaction and in the development of bilateral renal cortical necrosis.