ROBERTO MUSSO, M.D.; ROSARIO GIUSTOLISI, M.D.; ELIO CACCIOLA, M.D.
To the editor: Connors and coworkers (1) report that the adult respiratory distress syndrome, which may occur after endoscopic variceal sclerotherapy using sodium morrhuate, was not dependent on direct vascular injury from the sclerosing agent. They, therefore, suggest that some other cause is to be considered.
We report that one cause in the development of the syndrome might be a direct activation of the contact system in the early phase of blood coagulation during or after sclerotherapy with sodium morrhuate. In fact, the contact system activation is a biological process closely linked to kinins and complement system activation, which in
MUSSO R, GIUSTOLISI R, CACCIOLA E. Acute Respiratory Distress During Sclerotherapy for Esophageal Varices. Ann Intern Med. ;106:640. doi: 10.7326/0003-4819-106-4-640_1
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Published: Ann Intern Med. 1987;106(4):640.
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