Hemorrhage of thiamine-deficient encephalopathy

Hemorrhagic lesions of pyrithiamine-induced acute thiamine-deficient encephalopathy of the mouse (PIATDEM) consisted of petechiae, which often coalesced to form small hematomas. Electron microscopy showed the typical petechial lesion to be composed of a perivascular necrotic zone containing fibrin-platelet clot surrounded by a ring of erythrocytes. Endothelial cells were intact and tight junctions were closed. A study of permeability to horseradish peroxidase (HRP) revealed only a slight increase in the number of transport vesicles in the endothelial cells. A large amount of HRP present in the lesions seemed to have entered the brain by a hemorrhagic route which remains unclarified. Spherical latex particles, 0.23 micrometer in diameter, were injected intravenously into encephalopathic mice at a time when intracerebral hemorrhages frequently occurred. Two to 24 hours after the injection, a large number of latex particles penetrated the blood vessels at sites of hemorrhage. There were many particles in the phagosomes of the endothelial cells, which suggested transendothelial transport by the organelle. The possibility of endothelial phagocytic transport of erythrocytes as a main route of diapedesis is discussed.