Granuloma Symptoms and Related Conditions

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A granuloma is a tiny lump of inflamed tissue in the body that gets its name from looking like a grain of sand or sugar. Sometimes granulomas harden and can be seen on an X-ray. To confirm the diagnosis, a tissue sample is taken through a biopsy and examined under a microscope.

The body produces granulomas as a way to block out certain irritants that it is unable to ward off, and these lumps can form in tissues throughout the body, affecting how organs, like the lungs or eyes, work. Certain diseases are characterized by the formation of granulomas.

Sarcoidosis

Sarcoidosis is a rare disease that occurs when many granulomas form as a result of inflammation in the body and clump together, affecting organ function. Experts believe that the granulomas form as an immune system response to something in the environment, but it's not clear what.

Symptoms of sarcoidosis depend on the organs where granulomas have formed, although many people will have only mild symptoms or no symptoms at all. Some people with sarcoidosis develop Lofgren's syndrome, an acute form of the disease characterized by fever, enlarged lymph nodes, and erythema nodosum (a red or reddish-purple rash on the ankles and shins).

The lungs will be involved in more than 90% of sarcoidosis cases, manifesting with shortness of breath, coughing, and chest tightness or discomfort.

Treatment for sarcoidosis depends on which organs are affected by granulomas. Topical treatments and medications can be prescribed to treat sarcoidosis. However, not all people with sarcoidosis will need treatment. 

Other Granulomatous Conditions

Sarcoidosis is just one condition where granulomas are present in the body. There are other granulomatous conditions commonly seen by doctors:

Granuloma Annulare

Granuloma annulare occurs when raised, red or skin-colored bumps form in ring patterns. These bumps, called lesions, usually turn up on the hands and feet. The condition usually isn't painful or itchy, and will typically go away on its own without treatment within two years. Experts aren't sure what causes these granulomas to form.

Crohn's Disease

Granulomas that form in the intestines or colon are a distinguishing characteristic of Crohn's disease. They can't be found during a colonoscopy but can be seen in a biopsy. The presence of granulomas can help doctors make a diagnosis, as granulomas do not form in people with ulcerative colitis, another major form of inflammatory bowel disease (IBD).

Granulomatosis with Polyangiitis

Granulomas that form in the lungs, kidneys and small blood vessels are characteristic of granulomatosis with polyangiitis (formerly known as Wegener granulomatosis), a rare autoimmune disease. Symptoms of the disease depend on where the granulomas have formed.

Depending on the organs involved, granulomatosis with polyangiitis may cause shortness of breath, fatigue, weight loss, a crusting pus-like drainage from the nose, and numbness of legs, arms, fingers, or toes.

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  1. Baughman RP, Culver DA, Judson MA. A Concise Review of Pulmonary Sarcoidosis. Am J Respir Crit Care Med. 2011 Mar 1;183(5):573-81. doi:10.1164/rccm.201006-0865CI

  2. Greco A, Marinelli C, Fusconi M. et al. Clinic manifestations in granulomatosis with polyangiitis. Int J Immunopathol Pharmacol. 2016 Jun;29(2):151-9. doi:10.1177/0394632015617063

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