Mori W
Histopathology. 1981 Mar;5(2):113-26. doi: 10.1111/j.1365-2559.1981.tb01772.x.
The Shwartzman reaction was first described more than 50 years ago and two types, the generalized and the localized, were established in the early 1930s. Studies were mostly related to experimental pathology or immunology, and its significance in clinical medicine was initially obscure though thought to be obstetrically relevant. It is thought that the generalized type has a relation to human disease and that disseminated intravascular coagulation in man is really the counterpart of the generalized Shwartzman reaction in animals. The localized type on the other hand does not have obvious practical clinical pathological significance and tumor necrosis may be the only real example which is commonly seen. Further studies on the Shwartzman reaction relevant to human pathology have, however, suggested that it could be applied to several diseases, the pathogenesis of which was still obscure. The significance seems, however, different from either the generalized or localized type of reaction and so a proposal of the incidence of a third type--'univisceral' or 'single organ' Shwartzman reaction is made. Acute liver necrosis, Waterhouse-Friderichsen's syndrome, haemolytic uraemic anemia, idiopathic pulmonary haemorrhage, acute pancreatitis, acute pituitary necrosis and pseudomembranous colitis all seem to have features suggesting that they could be clinical manifestations of this type of Shwartzman reaction with focal intravascular coagulation.
施瓦茨曼反应于50多年前首次被描述，20世纪30年代初确定了两种类型，即全身性和局限性。研究大多与实验病理学或免疫学相关，其在临床医学中的意义最初并不明确，尽管被认为与产科有关。人们认为全身性类型与人类疾病有关，人类的弥散性血管内凝血实际上是动物全身性施瓦茨曼反应的对应物。另一方面，局限性类型没有明显的实际临床病理意义，肿瘤坏死可能是唯一常见的真实例子。然而，对与人类病理学相关的施瓦茨曼反应的进一步研究表明，它可应用于几种发病机制仍不明确的疾病。然而，其意义似乎不同于全身性或局限性反应类型，因此提出了第三种类型——“单脏器”或“单一器官”施瓦茨曼反应发生率的提议。急性肝坏死、华-弗综合征、溶血性尿毒症性贫血、特发性肺出血、急性胰腺炎、急性垂体坏死和假膜性结肠炎似乎都有一些特征，表明它们可能是这种伴有局灶性血管内凝血的施瓦茨曼反应的临床表现。
