In the name of Allah the most Beneficent, the most Merciful

SYSTEMIC EFFECTS OF ACUTE

INFLALMATIONAND

GRANULOMA

BY: MASOOMA SHAHZADI

Inflammation is a protective tissue response to injury or destruction of tissues, which serves to destroy, dilute, or wall off both the injurious agent and the injured tissues.

INFLAMMATION

ACUTE INFLAMMATION

Reaction of a tissue & its microcirculation to a pathogenic insult.

A complex reaction in vascularized connective tissue.

Characterized by movement of fluid and neutrophils from blood into extra vascular tissues by generation of chemical mediators.

It occurs over seconds, minutes, hours, and days, of the tissue injury and end when the injurious stimulus has been removed.

ACUTE INFLAMMATION

•HeatCALOR

•RednessRUBOR

•SwellingTUMOR

•PainDOLAR

•Loss Of FunctionFUNCTIO LAESA

CARDINAL SIGNS OF ACUTE INFLAMMATION

SYSTEMIC EFFECTS OF

ACUTE INFLALMMATION

They are collectively called the acute-phase reaction, or the systemic inflammatory response syndrome.

The cytokines produced by leukocytes TNF, IL-1, and IL-6 are the most important mediators, leading to systemic effects.

IL-6 stimulates the hepatic synthesis of a number of plasma proteins.

SYSTEMIC EFFECTS OF ACUTE INFLALMMATION

temperature > 37.8oC or >100 F Increased pulse & blood pressure Chills Anorexia

FEVER or PYREXIA

Neutrophilia: Increased number of neutrophils, indicating bacterial infection.

Lymphocytosis: Increased number of lymphocytes, indicating viral infection.

Eosinophilia: in allergy or parasitic infection

LEUKOCYTOSIS

Fibrinogen CRP SAA leads to increased ESR

Acute Phase Protein Production In Liver

Increased erythrocyte sedimentation rate due to increased production of acute phase proteins and reactants.

In the presence of acute phase reactants (fibrinogen) erythrocytes aggregate due to loss of their negative charge resulting in increased sedimentation.

Increased ESR

Complete resolution

Abscess formation (encapsulation

and pus)

Chronic inflammation

Healing with scar formation

OUTCOME OF ACUTE INFLAMMATION

CHRONIC INFLAMMATION

If the condition causing acute inflammation is not resolved, the inflammation may pass to a longer term chronic phase.

Chronic inflammation is from days to years.

Mainly macrophages and lymphocytes are present.

Proliferation of blood vessels, fibrosis and necrosis takes place.

CHRONIC INFLAMMATION

GRANULOMATOUS

INFLAMMATION

Granulomatous inflammation is a distinctive pattern of chronic inflammatory reaction.

It is a protective response to chronic infection or foreign material, preventing dissemination and restricting inflammation.

Some autoimmune diseases such as rheumatoid arthritis and Crohns disease are also associated with granulomas.

Definition

MECHANISMOF

GRANULOMA FORMATION

A granuloma is a microscopic aggregation of macrophages that are transformed into epithelium-like cells(epitheloid cells) surrounded by a collar of mononuclear leukocytes.

Principally lymphocytes and occasionally plasma cells are present.

Fibrous connective tissue often surrounds granulomas.

GRANULOMA

Epithelioid cells fuse to form giant cells containing 20 or more nuclei.

The nuclei arranged either peripherally (or in horse shoe shape), called Langhans-type giant cell or

haphazardly called foreign body-type giant cell.

These giant cells can be found either at the periphery or the center of the granuloma.

GRANULOMA

Centrally placed necrosis

Surrounded by epitheliod cells

An outer layer of lymphocytes

Plasma cells may be present

Few Giant cells present

Surrounded by fibrin and connective tissue

COMPONENTS OF GRANULOMA

Foreign Body Granuloma Form when material such as talc, sutures,

or other fibers are large enough to preclude phagocytosis by a single macrophage.

Immune Granuloma Caused by insoluble particles that are

capable of inducing a cell-mediated response. This type of immune response produces granulomas when the inciting agent is poorly soluble or particulate.

TYPES OF GRANULOMA

CAUSES OF GRANULOMATO

US DISEASE

1. Bacteria

Tuberculosis

Leprosy

INFECTIOUS CAUSES

TUBERCULOSIS

TUBERCULOSIS

Caseating Granuloma

Foreign body Berylliosisgranuloma granuloma

THANK YOU!