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KMID : 0376219750120030713
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Chonnam Medical Journal
1975 Volume.12 No. 3 p.713 ~ p.731
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Histological Studies on the Renal Papillary Necrosis
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Abstract
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In order to investigate the pathogenesis of renal papillary necrosis, an experiment was carried out by injecting fresh human serum to the rats. Histologic and histochemical studies were made with stress on the early changes, and the possible mechanism involved in the lesion process was discussed. The results were as follows.
1. Three hours after the injection, the thin segments of Henle´s loops showed mild swelling and the tributaries of arteriolae rectae revealed moderately constricted pattern.
2. After eight hours, thrombi occluded many of the tributaries of arteriolae rectae which were mildly necrotic. The mild necrotic change also captured the whole Henle´s loops, in which epithelial cells revealed cytoplasm with eosinophilic droplets.
3. The necrotic process extended to the collecting tubules in the papillary area twenty-four hours after the injection, further to the papillary tips and deep cortical area after forty-eight hours.
4. ATPase activity decreased in the blood vessels, collecting tubules and Henle´s loops in the necrotic area, whereas AcPase activity increased slightly. PAS positivity was strong in the eosinophilic material and showed concordant change with it. The eosinophilic material - was appeared as droplets, small masses, and in the more necrotic area, as patch or cast-like. The observable pathologic changes were initiated with accumulation of the eosinophilic material, initially ´in the endothelium of the blood vessels, thence in the Henle´s loops, collecting tubules, and papillary interstitial tissue as the process advanced. The vascular system was affected more severely than the tubular system all over the lesion process.
The lesion m~oh d Ai1s´t the papillae area and the -inner st1ifcs-´of yttipT; outer. zone of the,; medulla;. end;furthered to the deep cortical area.
In the development of renal papillary necrosis by heterologous fresh serum the cy-toaoxic effect of the serum seemed to promote the ischemic necrosis caused by swelling of the thin- segments and ascending limbs of Henle´s loops and constriction of arteriolae rectae.
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