A light- and electron-microscopic study of the so-called uni-visceral Shwartzman reaction

A morphological study was made on a particular model of Shwartzman reaction which was so designed as to occur mainly in the liver with minimal influence to the other parts of the body. The study was mainly focused on its mechanism; the role of the granulocytes, Kupffer cells, platelets and precipitated fibrin. It was revealed that Kupffer cells were severely damaged by the first, preparative injection and the most conspicuous finding after the second, provocative injection was marked granulocytic infiltration followed by massive hepatic cell necrosis. The infiltrating granulocytes sticked to the endothelium, degenerated Kupffer cells, or other granulocytes and, often aggregated around precipitated fibrin. The erythrocytes in the sinusoid also showed aggregation after the provocative injection of the endotoxin, which was, however, rather loose and easily washed out from the sinusoid by perfusion. It is suggested from the above observations that aggregation of granulocytes as well as precipitated fibrin plays an important role to disturb blood stream mechanically and leads to massive necrosis in the liver.