Pathogenesis of the Histamine Shock

Abstract

In this study were reviewed the results of experiments on 580 rabbits made in order to explain the pathogenesis of the histamine shock. The reactions of blood vessels and microscopic changes were examined, the behaviour of the endothelial cells, platelets and clotting factors, morphological changes of cells and organs, the appearance of morphological equivalents of disseminated intravascular coagulation (DIC). This investigation was made in all developing phases of histamine shock and in recovery period of 5 days. By electron microscopic and interference microscopic investigation compared to their findings, we got some new information, which show us in a new light a development of the histamine shock.

It is possible to conclude that primary processes are not spastic disorders of local circulation. “Lungensperre” either in lesions of capillar permeability and consequent oligemia, but they are a consequence of embolic obstruction of pulmonary capillars and capillars of the other organs as well by accumulation of agglutinated platelts, which afterwards locally become the fibrin microthrombi. Aggregation and aglutination of platelets, which later break the whole system of hemostase and produce the picture of DIC-syndroma in which is included coagulopathy of the consumption.

This is provoked probably by direct influence of histamine on platelet membranes or elements of gramulomera.

Microthrombotic obstruction of pulmonary capillars in histamine shock represents that real substratum of so called “Lungensperre” which existence was by physiological methods registered in the time of Dale, but nowadays is morphologically visualised. Disorder of capillar perfusion in many important organs which appears simultaneously and is provoked by above mentioned mechanism, is also a manifestation of DIC and is responsible for pass of histamine shock in irreversible phase i. e. lethal exit.