Show Summary Details
Page of

Hepatic granulomas 

Hepatic granulomas

Hepatic granulomas

C.W.N. Spearman

, M.W. Sonderup

, and S.J. Saunders



Description of hepatic manifestations of immune reconstitution inflammatory syndrome in HIV/AIDS.

Updated on 30 Nov 2011. The previous version of this content can be found here.
Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2015. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy).

date: 30 March 2017

Granuloma formation occurs when persistent antigenaemia or poorly degradable antigens, such as chemicals or toxins, provide an ongoing stimulus that results in the focal accumulation of activated lymphocytes and macrophages, with the macrophages undergoing epithelioid transformation.

The diagnosis of granulomatous hepatitis is usually made during the investigation of a systemic illness, often presenting as pyrexia of unknown origin. Serum liver transaminases are frequently normal, but alkaline phosphatase and γ‎-glutamyltransferase levels may be elevated. The histomorphology of the granuloma, their distribution in the liver and special stains, e.g. Ziehl–Neelsen for mycobacteria and methenamine silver for fungi, may yield a definite diagnosis.

The causes of hepatic granulomas vary depending on the patient population and country studied. In the developed world most cases are due to sarcoidosis, primary biliary cirrhosis or are drug-induced, whilst infectious causes such as mycobacterial infections, schistosomiasis and AIDS-related infections predominate in the developing world.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can''t find the answer there, please contact us.