Experimental Adrenal Gland Necrosis by Massive Intravascular Coagulation and the Effect of ACTH

Waterhouse-Friederichsen-syndrome is considered today as one of the human manifestations of the generalized Shwartzman-phenomenon with disseminated intravascular coagulation. There is however a discrepancy between the findings in the phenomenon in the rabbit and the human disease, in that hemorrhagic infarction of the adrenals is inconspicuous in the first and frequent in the latter. The pathogenesis of the adrenal changes were studied by examining the effect of massive intravascular coagulation induced by intravenous heparinoid Liquoid-followed by an infusion of epsilon-amino-capronic acid-on the adrenal cortex. With our method ishemic infarction of the adrenal cortex could be produced in a high percentage of animals. Simultaneous administration of ACTH reduces significantly the number of fibrin thrombi and the extent of ishemic necrosis in the adrenal cortex. On the other hand it probably enhances the well known cortical hemorrhages in the early phase of the experiment.