Pathologic anatomy

Pathological changes in the hypervitaminosis D2 understudied and literary few data. The first reports based on experimental data, appeared in the late 20's - early 30's, (Shohl a. oth., 1930; Ham, 1932). However, in subsequent years, have already been described pathological changes in individual patients, died from gipervitaminoza D. According to Y. B. Vishnevskogo, in world literature until 1949 mentions 16 deaths associated with large doses of vitamin D. Then were published only a few messages. So, in the domestic literature over the past 15 years pathomorphological data described only 9 patients who died of hypervitaminosis D2 (Pleskava, 1962; Barlybaeva, Strukov, 1974; Tabolin and others, 1974).
According to Y. B. Vishnevskogo (1970), from 73 observed patients with D-vitamin a intoxication death had 2; according to M. I. Shevlyagina registered one case of 24 sick children. Of the 107 we see children with hypervitaminosis D died 4 (3,7%). Thus, the mortality of hypervitaminosis D in children is quite high and exceeds mortality from pneumonia.
About the frequency of deaths in the hypervitaminosis D is difficult to judge. This is because due to insufficient acquaintance with this pathology is not always possible to make a correct diagnosis. It is necessary to consider the fact that children with symptoms of hypervitaminosis D usually die from layer these areas using infections, mostly pneumonia. And. targeted research is usually not performed, so characteristic of this disease morphological changes remain unrecognized.
This Chapter presents the main results of experimental pathological studies, as well as analysis of autopsy data of four children died from vitamin a intoxication conducted jointly with patomorphology B. N. Surkovym and B. C. Muzykantova. In the work are widely used various methods of the research histological, histochemical, gastoenteritis, electron microscopy and other
In macroscopic research of 85 dead animals with the manifestation of hypervitaminosis D2 was observed plethora of vessels of internal organs. In 14 out of them under the Dura mater lumbar spinal cord was found dark red bleeding without clear boundaries. Vessels soft meninges was always full and extended. The anatomical location of the chest and abdominal cavity correct. The surface of the pleura and peritoneum wet and dull. The lungs are not fully filled the chest and places clung to the root. Mucous clearance bronchi and trachea was with a full vessel. Under the visceral pleura of the lungs, especially between shares, were found petechial hemorrhage. Light is often sealed, and on cuts worthwhile. The language is generally clean, but a bit dry. The esophagus is empty, often noted some of its blueness. The mucous membranes of the stomach, small and large intestines were with full vessel. Lobe of the liver looked usually increased, and the bottom edge slightly rounded. The liver tissue on cuts full-blooded, dull brown tint. The pancreas also full, slightly increased. Some animals (10) found subcapsular hemorrhage.
When expressed clinical manifestations of hypervitaminosis D under the epicardial and endocardial heart animals were of various sizes dark red spotted hemorrhage. Heart feels tight, its cavity enhanced. Myocardium experimental animals, starting with total doses of vitamin D, equal to about 300,000 ME, got homogeneous, brown-red dull.
Spleen in all animals was dark red with a slightly wrinkled capsule, on cuts pulp cherry, moderate blood. In addition, 3 of the animals under the capsule spleen found eruption hemorrhage.
The first visible changes in the kidneys of animals with experimental hypervitaminosis D usually determined from the total cumulative dose of vitamin D2, equal to 300 000 ME. Buds with the surface was dull, and on cuts worthwhile. At a total dose of 400 000 ME and more on the border between cortical and brain layers appear dark red blotches, simultaneously increased vascular plethora and dullness membranes of the renal pelvis. Bladder was usually filled with urine.