Summary1) Intravenous injection of small amounts of nephrotoxic serum produced a syndrome in rats whose characteristics include proteinuria and proliferation of glomerular endothelial cells. This dosage of nephrotoxic serum was well tolerated by the rats. 2) Rats were shown to tolerate E. coli lipopolysaccharide endotoxin over a wide range of dosages. 3) Simultaneous injection of nephrotoxic serum and minute amounts of Gram-negative bacterial endotoxin resulted in acute death in a high percentage of rats and renal lesions resembling those of the generalized Shwartzman reaction. 4) The possible implications of these observations on susceptibility to necrotizing effects of endotoxin-like substances and on the pathogenesis of renal disease are discussed.
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