Chronic and granulomatous inflammation
How chronic inflammation differs from acute, how granulomas form and are maintained by IFN-gamma and TNF, the causes of granulomatous disease, and the clinical consequences examined in Paper 1, from hypercalcaemia in sarcoidosis to TB reactivation on anti-TNF therapy and AA amyloidosis.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Chronic inflammation lasts weeks to years. Inflammation, tissue destruction and repair happen at the same time, with macrophages, lymphocytes and plasma cells, new vessels and fibrosis.
- It follows persistent infection, prolonged exposure to a toxic or indigestible agent, or autoimmunity.
- Granulomatous inflammation is a pattern of chronic inflammation in which activated macrophages wall off an agent the body can't clear. IFN-γ builds the granuloma and TNF maintains it.
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Sources
- Robbins and Cotran Pathologic Basis of Disease (10th ed.)Elsevier (Kumar, Abbas and Aster, 2020), 2020
- Pagán AJ, Ramakrishnan L. The formation and function of granulomas. Annu Rev Immunol 2018;36:639-65Annual Review of Immunology, 2018
- Grunewald J et al. Sarcoidosis. Nat Rev Dis Primers 2019;5:45Nature Reviews Disease Primers, 2019
- Keane J et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 2001;345:1098-104New England Journal of Medicine, 2001
- Therapeutic Guidelines: Antibiotic (latent tuberculosis infection)AU/NZTherapeutic Guidelines Limited, 2025
- Last updated
- 14 November 2026
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