From Big Medical Encyclopedia

SANARELLI-ZDRODOVSKOGO PHENOMENON (G. Sanarelli, ital. hygienist, 1864 — 1940; P.F. Zdrodovsky, owls. the microbiologist) — the anaphylactoid hemorrhagic syndrome which is sharply developing at introduction of homological or heterologous bacteritic products and characterized by widespread defeat of capillaries of vascular system.

Originally the phenomenon was described by Sanarelli in 1923 as «cholera algid», reproduced at the rabbits infected with intravenously tolerant dose of a cholera vibrio with intravenous administration by this animal in 24 hours of a tolerant dose if - or proteotoxin (a filtrate of bouillon cultures). Further (1924 — 1925) in P.F. Zdrodovsky's laboratory it was shown that experimental «cholera algid» Sanarelli is a special case of group of the anaphylactoid phenomena (see. Anaphylactoid reactions ), to-rye it is possible to reproduce on rabbits in various conditions gomo-and a heterologous sensitization their bacterial and animal protein with the subsequent intravenous administration of a filtrate of bouillon cultures of these or those microbes (colibacillus, a protea, Danish's sticks, etc.). So, in P.F. Zdrodovsky's laboratory the phenomenon was reproduced at various schemes of experiences: cholera (or choleroid) a vibrio + prick - or proteotoxin, colibacillus + kolitoksin, proteas + proteotoxin, protein of egg + kolitoksin etc. At the same time it was shown that the phenomenon can be reproduced also at a sensitization of an animal by enteral introduction of a filtrate of bouillon cultures of various microbes.

Irrespective of a way of reproduction, the developing syndrome was stereotypic and corresponded to the original phenomenon described by Sanarelli. At all schemes of statement of experiences the phenomenon was similar as the pathoanatomical changes which are especially sharply expressed at the subacute course of reaction. At the dead of animals note a hyperemia of a peritoneum, quite often hemorrhages in a big epiploon, defeats of capillaries and hemorrhage of various degree of manifestation and localization (lungs, kidneys, intestines, sometimes — hypodermic cellulose). To hemorrhages there corresponds very sharp systemic lesion of an endothelium of capillaries with his fatty dystrophy. Along with it note dystrophy, a necrosis and rejection of an epithelium of a mucous membrane of a small bowel with enteritis of various intensity and characteristic damage of kidneys in the form of a nephrosonephritis with hemorrhages (a spotty kidney). Perhaps also formation of the ulcers in intestines developing on site hemorrhages, appendicitis with formation of the necrotic centers in group lymphatic follicles of a worm-shaped shoot, a hemorrhagic imbibition of group lymphatic follicles of a small bowel (peyerovy plaques) and development of hemorrhagic forms of colitis, sometimes with a diphtheritic necrosis of a mucous membrane.

Later a considerable variety of combinations was revealed, at to-rykh the described anaphylactoid reactions are reproduced. So, at the Guinea pigs prepared by intraperitoneal introduction of a filtrate from bouillon culture of colibacillus at the subsequent (in 2 weeks) infection of an eye with a diphtheritic stick the malignant, fatally terminating diphtheria is reproduced. Intravenous administration of a filtrate of bouillon culture of colibacillus to the rabbit imparted by a smallpox vaccine in addition to hemorrhages around pockmarks (in a stage of a papular rash), can cause hemorrhagic-nekrotiche-skoye damage of a mucous membrane of all large intestine (the death of an animal came in 7 days after introduction of a filtrate of culture).

Zh. Borde observed fatally terminating hemorrhagic syndrome at the Guinea pigs intraperitoneally imparted by a vaccine BTSZH (see), under the influence of the subsequent (in 2 — 3 weeks) intravenous or intraperitoneal administration of a filtrate of bouillon culture of colibacillus by it or a protea.

According to P.F. Zdrodovsky, S. — 3. t. can have a certain value in different pathogeny inf. defeats (nek-ry forms of enteritis, damages of kidneys, cankers in intestines, appendicitis, etc.)*. The infection slight in itself in connection with weak pathogenic properties of the activator, can gain difficult character, causing sharp sensitization of an organism to other microbes, to-rye can be mobilized as microbes of an exit during primary infection. Microbes of an exit, also low-pathogenic, can cause, however, accident at impact on a sensibilized organism.

In 1932 A. Gratia and Linz (R. Linz) combined on the pathogenetic mechanism C. — 3. t. and Shvarttsman's phenomenon (see. Shvarttsmana phenomenon ) under the name «hemorrhagic heteroallergy», having highlighted the dominating value in both phenomena of hemorrhagic defeats. However the term «heteroallergy» is not exact as both phenomena can be reproduced also in homological system and, besides, immune mechanisms do not take part in their development.

See also Anaphylaxis , Sensitization .

Bibliography: Zdrodovsky P. F. A problem of reactivity in the doctrine about an infection and about immunity, page 77, M., 1950; Zdrodovsky P. F. and Brenna. To a pathogeny of cholera and an algidny state, Works Azerbaijan to. in-that micro-biol. and gigabyte., century 1, page 1, Baku, 1925; about N and, To a pathogeny of the experimental algid described by Sanarelli (Materials to the characteristic of the phenomena anafilaktoi - yes), in the same place, century 2-3, page 164, Baku, 1925 — 1926; Cassuto N. II fenomeno di Sanarelli — Shwartzman, Boll. 1st. sieroter. milan., v. 12, p. 787, 1933; Gratia A. e t Linz R. L’allergie hemorragique, Ann. Inst. Pasteur, t. 50, p. 89, 1933; S a-n a r e 1 1 i G. De la pathogenie des etats algides dans le cholera, ibid., t. 37, p. 364, 806, 1923; it, Le cholera experimental, ibid., t. 38, p. 11,1924; T h o m a s L. Good R. A. Effect of cortisone on Shwartzman reaction, J. exp. Med., v. 95, p. 409, 1952; they, Studies on the generalized Shwartzman reaction, ibid., v. 96, p. 605; Zdrodowski P. Re-cherches experimentales sur la pathogenie du cholera, Ann. Inst. Pasteur, t. 42, p. 1242, 1928.

P.F. Zdrodovsky.