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Environ Health Perspect. Oct 1996; 104(Suppl 5): 945–947.
PMCID: PMC1469698
Research Article

Chronic beryllium disease: diagnosis and management.

Abstract

Chronic beryllium disease is predominantly a pulmonary granulomatosis that was originally described in 1946. Symptoms usually include dyspnea and cough. Fever, anorexia, and weight loss are common. Skin lesions are the most common extrathoracic manifestation. Granulomatous hepatitis, hypercalcemia, and kidney stones can also occur. Radiographic and physiologic abnormalities are similar to those in sarcoidosis. While traditionally the pathologic changes included granulomas and cellular interstitial changes, the hallmark of the disease today is the well-formed granuloma. Immunologic studies have demonstrated a cell-mediated response to beryllium that is due to an accumulation of CD4+ T cells at the site of disease activity. Diagnosis depends on the demonstration of pathologic changes (i.e., granuloma) and evidence that the granuloma was caused by a hypersensitivity to beryllium (i.e., positive lung proliferative response to beryllium). Using these criteria, the diagnosis of chronic beryllium disease can now be made before the onset of clinical symptoms. Whether, with early diagnosis, the natural course of this condition will be the same as when it was traditionally diagnosed is not known. Currently, corticosteroids are used to treat patients with significant symptoms or evidence of progressive disease.

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Selected References

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  • Stoeckle JD, Hardy HL, Weber AL. Chronic beryllium disease. Long-term follow-up of sixty cases and selective review of the literature. Am J Med. 1969 Apr;46(4):545–561. [PubMed]
  • Aronchick JM, Rossman MD, Miller WT. Chronic beryllium disease: diagnosis, radiographic findings, and correlation with pulmonary function tests. Radiology. 1987 Jun;163(3):677–682. [PubMed]
  • Newman LS, Buschman DL, Newell JD, Jr, Lynch DA. Beryllium disease: assessment with CT. Radiology. 1994 Mar;190(3):835–840. [PubMed]
  • Rossman MD, Kern JA, Elias JA, Cullen MR, Epstein PE, Preuss OP, Markham TN, Daniele RP. Proliferative response of bronchoalveolar lymphocytes to beryllium. A test for chronic beryllium disease. Ann Intern Med. 1988 May;108(5):687–693. [PubMed]
  • Andrews JL, Kazemi H, Hardy HL. Patterns of lung dysfunction in chronic beryllium disease. Am Rev Respir Dis. 1969 Dec;100(6):791–800. [PubMed]
  • Freiman DG, Hardy HL. Beryllium disease. The relation of pulmonary pathology to clinical course and prognosis based on a study of 130 cases from the U.S. beryllium case registry. Hum Pathol. 1970 Mar;1(1):25–44. [PubMed]
  • Kreiss K, Mroz MM, Zhen B, Martyny JW, Newman LS. Epidemiology of beryllium sensitization and disease in nuclear workers. Am Rev Respir Dis. 1993 Oct;148(4 Pt 1):985–991. [PubMed]
  • Kreiss K, Wasserman S, Mroz MM, Newman LS. Beryllium disease screening in the ceramics industry. Blood lymphocyte test performance and exposure-disease relations. J Occup Med. 1993 Mar;35(3):267–274. [PubMed]
  • Williams WJ, Wallach ER. Laser microprobe mass spectrometry (LAMMS) analysis of beryllium, sarcoidosis and other granulomatous diseases. Sarcoidosis. 1989 Sep;6(2):111–117. [PubMed]
  • Kriebel D, Brain JD, Sprince NL, Kazemi H. The pulmonary toxicity of beryllium. Am Rev Respir Dis. 1988 Feb;137(2):464–473. [PubMed]
  • CURTIS GH. Cutaneous hypersensitivity due to beryllium; a study of thirteen cases. AMA Arch Derm Syphilol. 1951 Oct;64(4):470–482. [PubMed]
  • Marx JJ, Jr, Burrell R. Delayed hypersensitivity to beryllium compounds. J Immunol. 1973 Aug;111(2):590–598. [PubMed]
  • Deodhar SD, Barna B, Van Ordstrand HS. A study of the immunologic aspects of chronic berylliosis. Chest. 1973 Mar;63(3):309–313. [PubMed]
  • Epstein PE, Dauber JH, Rossman MD, Daniele RP. Bronchoalveolar lavage in a patient with chronic berylliosis: evidence for hypersensitivity pneumonitis. Ann Intern Med. 1982 Aug;97(2):213–216. [PubMed]
  • Cullen MR, Kominsky JR, Rossman MD, Cherniack MG, Rankin JA, Balmes JR, Kern JA, Daniele RP, Palmer L, Naegel GP, et al. Chronic beryllium disease in a precious metal refinery. Clinical epidemiologic and immunologic evidence for continuing risk from exposure to low level beryllium fume. Am Rev Respir Dis. 1987 Jan;135(1):201–208. [PubMed]
  • Saltini C, Winestock K, Kirby M, Pinkston P, Crystal RG. Maintenance of alveolitis in patients with chronic beryllium disease by beryllium-specific helper T cells. N Engl J Med. 1989 Apr 27;320(17):1103–1109. [PubMed]
  • Newman LS, Bobka C, Schumacher B, Daniloff E, Zhen B, Mroz MM, King TE., Jr Compartmentalized immune response reflects clinical severity of beryllium disease. Am J Respir Crit Care Med. 1994 Jul;150(1):135–142. [PubMed]
  • Hart BA, Harmsen AG, Low RB, Emerson R. Biochemical, cytological, and histological alterations in rat lung following acute beryllium aerosol exposure. Toxicol Appl Pharmacol. 1984 Sep 30;75(3):454–465. [PubMed]

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