- Abnormal collection of inflammatory cells (granulomas) throughout the body.
- Most common location for granulomas to occur are the lung, skin, heart, and brain.
- Exact cause unknown - thought to be related to an immune reaction to a prior insult such as infection or chemical exposure earlier in life.
- Do not confuse with infectious granulomatous processes such as tuberculosis.
Depend on location of granulomata. May be entirely asymptomatic.
- Erythema nodosum and other skin lesions
- Weight loss
- Histiocytosis X
- Wegener's granulomatosis
- Churg-Strauss syndrome
- Rheumatoid arthritis
- Polymyalgia rheumatica
- Definitive initial diagnosis unlikely to be made in ED, but may be suggested by typical granulomatous lesions seen on CT or other imaging in setting of appropriate clinical context
- Evaluate for complications/alternative diagnoses of presenting symptoms
- Treat complications
- Dependent on presentation
- James WD, Berger TG, Elston DM. Macrophage/Monocyte Disorders. In: James WD, Berger TG, Elston DM (eds). Andrews’ Diseases of the Skin, 12e. Philadelphia, PA: Elsevier; 2016, Chapter 31.