Thompson J C
J Comp Pathol. 1986 Sep;96(5):517-27. doi: 10.1016/0021-9975(86)90072-1.
Haemoglobinaemia is seen in certain hosts infected by certain serovars of Leptospira interrogans, but is absent from other serovar-host associations. Comparisons were made between calves infected with serovar pomona and those receiving a crude "toxin" prepared from the same organism. Red blood cells from "toxin"-injected calves showed discocyte-echinocyte transformation and contained portions of cytoplasm segregated within vacuoles. These animals showed increased sequestration of RBCs within the spleen but no overt haemoglobinaemia. Red blood cells from infected and haemoglobinaemic animals were spherical and pitted. They also showed vacuoles and tracts under the cell membrane in fully haemoglobinized RBCs and dark granular inclusions within the cytoplasm of those which were only partially haemoglobinized. Intracellular leptospires were not seen within the RBCs. Red blood cell sequestration and erythrophagocytosis were very pronounced within the spleen, liver and bone marrow. The changes in the RBCs are not easily explained by the previously proposed theory that RBC destruction is due to a phospholipase-like toxin acting directly upon the RBC membrane. A more appropriate hypothesis is that the RBC lesions are due to the adverse effects of leptospiral "toxin(s)" on the metabolism of the RBC causing the formation of defective portions of cytoplasm. These are then either degraded and expelled, leaving empty vacuoles, or are degraded and left within the cytoplasm as dark granular inclusions.
血红蛋白血症在感染问号钩端螺旋体某些血清型的特定宿主中可见，但在其他血清型与宿主的组合中则不存在。对感染波摩那血清型的小牛与接受由同一生物体制备的粗制“毒素”的小牛进行了比较。注射“毒素”的小牛的红细胞显示出圆盘状红细胞-棘状红细胞转化，并且含有分隔在液泡内的部分细胞质。这些动物脾脏内红细胞的隔离增加，但没有明显的血红蛋白血症。来自感染且有血红蛋白血症动物的红细胞呈球形且有凹痕。它们在完全血红蛋白化的红细胞中还显示出细胞膜下的液泡和通道，而在仅部分血红蛋白化的红细胞的细胞质内则有深色颗粒状内含物。在红细胞内未见到细胞内钩端螺旋体。红细胞在脾脏、肝脏和骨髓内的隔离和红细胞吞噬作用非常明显。红细胞的这些变化很难用先前提出的理论来解释，即红细胞破坏是由于一种类似磷脂酶的毒素直接作用于红细胞膜。一个更合适的假说是，红细胞损伤是由于钩端螺旋体“毒素”对红细胞代谢的不利影响，导致细胞质中形成有缺陷的部分。然后这些部分要么被降解并排出，留下空泡，要么被降解并作为深色颗粒状内含物留在细胞质内。
