Nephrotoxic effects of tetanus toxin: An ultrastructural study

Abstract

Generalized nephrotoxicity was observed in the rat as early as 6 hr after intramuscular injection of 1000 of tetanus toxin. The most striking morphological changes, including swelling and rupture of the mitochondria, sloughing of the microvilli, and dissolution of cells, were found exclusively in the renal proximal tubule. Acute tubular necrosis with degeneration of the organelles and disruption of the cell membrane were also encountered throughout the entire nephron.Since these observations parallel those reported in patients with complicated acute tubular necrosis secondary to nephrotic syndrome and chemical toxicity, perhaps the kidney is one of the major targets in tetanus intoxication. It is possible that injury to the nephron results in electrolyte imbalance that can contribute to the neuromuscular manifestation accompanying tetanus toxicity.