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
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