Haemolysis in Acute Nephrotoxic Nephritis

摘要

The administration of absorbed nephrotoxic serum (NTS) to the laboratory rat produced immediate thrombocytopenia and hypofibrinogenaemia in addition to heavy proteinuria. Haemoglobinuria commonly occurred after a delay of 2-4 hours. Although plasma haemoglobin levels were frequently in excess of 100 mg/100 ml, haemoglobinuria developed in less severely affected animals with concentrations less than 20 mg/100/ml. Histological examination of the kidney showed glomerular fibrin in the capillary loops, which were frequently occluded with aggregated erythrocytes. It is suggested that intraglomerular coagulation is initiated by platelets in response to the direct antibody-antigen reaction on the glomerular basement membrane and leads to local haemolysis in the glomerular capillary loops. The statistically significant correlations of blood platelet, plasma fibrinogen and plasma haemoglobin values with glomerular histological damage and the absence of haematological disturbance in anephric animals given NTS support this proposal. In addition, it was observed that the sequence of immune reaction, platelet deposition and local coagulation was especially associated with the use of fresh antibody obtained after prolonged immunization.