What is the role of the Shwartzman phenomenon in the etiology of vascular and nonvascular hemostatic disorders?

Updated: Oct 06, 2020
  • Author: Irene S Pakos, DO; Chief Editor: Perumal Thiagarajan, MD  more...
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The Shwartzman phenomenon is defined as local or systemic vasculitis caused by a 2-stage reaction. An initial exposure to endotoxin produces intravascular fibrin thrombi whose clearance results in reticuloendothelial blockade. This prevents the clearance of thrombi generated by a second exposure to endotoxin, polyanions, glycogen, or antigen/antibody complexes, which leads to tissue necrosis and/or hemorrhage.

In pregnancy, gram-negative septicemia during delivery or abortion may serve as the first or provocative encounter. [59] The Shwartzman phenomenon is often associated with sepsis, the systemic inflammatory response syndrome (SIRS), and DIC.

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