Sanarelli-Shwartzman reaction

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Classification according to ICD-10
D69.8 Other specified hemorrhagic diatheses
ICD-10 online (WHO version 2019)

The Sanarelli-Shwartzman reaction (or Shwartzman reaction ) is a rare reaction of the body to endotoxins with thrombosis in the affected tissues .

It can be a shock ( toxic shock syndrome ) and necrosis of the adrenal cortex come.

Synonyms are: Ebbi-Shwartzman phenomenon; generalized Shwartzman phenomenon; (SSP); English Shwartzman reaction; Shwartzman Phenomenon ; Shwartzman-Sanarelli reaction

The first description of the generalized form comes from 1924 by the Italian researcher Giuseppe Sanarelli and the circumscribed form from 1928 by Gregory Shwartzman.

These were experimental investigations with intravenous or intradermal injection of sterile filtrates mainly of gram-negative bacteria in animal experiments . Two injections within 12–72 hours resulted in (local) skin necrosis or (systemic) shock reactions.

In humans , such reactions can include, for example:

distribution

This reaction is considered to be very rare in humans. Mostly it is septic abortion and meningococcal sepsis .

Clinical manifestations

Clinical criteria are:

  • acute febrile illness
  • hemorrhagic diathesis
  • Circulatory collapse usually within the first 24 hours, often resulting in death
  • Deposition of fibrin clots in the vessels of various organs

See also

literature

  • C. Ramírez-Hernández, G. Hernández-Vidal, A. Wong-González, E. Gutiérrez-Ornelas, MR Ackermann, R. Ramírez-Romero: Mast cell density during initiation and progression of the local Shwartzman reaction. In: Inflammation research: official journal of the European Histamine Research Society .. [et al.]. Volume 53, Number 3, March 2004, pp. 107-110, doi: 10.1007 / s00011-003-1229-x , PMID 15021965 .
  • G. Riemekasten, S. Ziemer, T. Häupl, C. Melzer, K. Loddenkemper, S. Hauptmann, GR Burmester, F. Hiepe: Shwartzman phenomenon in a patient with active systemic lupus erythematosus preceding fatal disseminated intravascular coagulation. In: Lupus. Volume 11, number 4, 2002, pp. 204-207, doi: 10.1191 / 0961203302lu193xx , PMID 12043882 .

Individual evidence

  1. ↑ Willibald Pschyrembel : Clinical Dictionary , 266th, updated edition, de Gruyter, Berlin 2014, ISBN 978-3-11-033997-0, keyword: Sanarelli-Shwartzman phenomenon
  2. ↑ a b Entry on Shwartzman syndrome in Flexikon , a wiki of the DocCheck company
  3. ↑ Encyclopedia Dermatology
  4. ↑ G. Sanarelli: De la pathogénie you choléra. Le choléra expérimental. In: Annales de l'Institut Pasteur. Vol. 37, 1924, pp. 8-80.
  5. ^ G. Shwartzman: Studies on Bacillus typhosus toxic substances. 1. Phenomenon of local skin reactivity to B. typhosus culture filtrate. In: The Journal of Experimental Medicine. Volume 48, number 2, July 1928, pp. 247-268, doi: 10.1084 / jem.48.2.247 , PMID 19869481 , PMC 2131457 (free full text).
  6. ↑ G. Shwartzman: A new phenomenon of local skin reactivity to B. typhosus culture filtrate. In: Proceedings of the Society for Experimental Biology and Medicine . Vol. 25, pp. 560-561, 1928
  7. ↑ AB Chahin, JM Opal, SM Opal: Whatever happened to the Shwartzman phenomenon ?. In: Innate Immunity. 24, 2018, p. 466, doi: 10.1177 / 1753425918808008 .
  8. ↑ Werner Köhler : Sanarelli, Giuseppe. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1284.
  9. ↑ U. Bleyl, W. Kuhn: Local and generalized Sanarelli-Shwartzman equivalent in the fetal human organism. In: Virchow's archive for pathological anatomy and physiology and for clinical medicine. Volume 343, Number 2, 1967, pp. 108-123, PMID 4873273 .
  10. ↑ G. Adebahr: About the generalized Shwartzman phenomenon in abortion. In: German journal for all forensic medicine. Vol. 54, August 1963, pp. 124-135, PMID 14082957 (review).
  11. ↑ a b A. Bohle, H. -J. Krecke: About the Sanarelli-Shwartzman phenomenon (so-called generalized Shwartzman phenomenon) in humans. In: Clinical weekly. Vol. 37, 1959, p. 803, doi: 10.1007 / BF01490468 .