Chronic beryllium lung disease
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose.
View Daniel J Bell's current disclosures- Pulmonary berylliosis
- Berylliosis involving lung
- Berylliosis - lung
- Chronic beryllium lung disease
- Chronic beryllium disease
- Chronic pulmonary berylliosis
Chronic beryllium lung disease (CBD) or sometimes just simply known as berylliosis refers to lung changes that can be seen with prolonged exposure to beryllium which is an alkaline earth metal that is used in many different industrial applications.
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Epidemiology
It is reported to occur in 2-5% of beryllium-exposed individuals.
Pathology
It is characterized by the development of granulomatous inflammation secondary to a cell-mediated immune response to beryllium.
While it is a multisystem granulomatous disease, it predominantly involves the lungs.
It is sometimes classified as a form of fibrotic pneumoconiosis as well as a type of pulmonary granulomatous disease. Although some authors describe this to represent a hypersensitivity disorder rather than a true pneumoconiosis 7.
The following criteria need to be present for a definitive diagnosis:
history of beryllium exposure
positive blood or bronchoalveolar lavage (BAL) beryllium lymphocyte proliferation test (BeLPT)
non-caseating granulomas on lung biopsy
Radiographic features
Its imaging features are said to be indistinguishable from pulmonary sarcoidosis 10.
CT
Reported CT findings have been shown to be variable and non-specific and include:
pulmonary nodularity is considered relatively common 1,2,6
patterns consistent with upper lobe fibrosis 1
diffuse interstitial fibrosis pattern 1
Mediastinal and hilar lymphadenopathy may also be present in a proportion of cases. In certain situations, ground-glass changes may also be seen 3.
Treatment and prognosis
While there is no cure, commonly adopted management options involve cessation of beryllium exposure and use of systemic corticosteroids 4. Early treatment with corticosteroids may lead to disease regression and prevent further progression. If fibrosis has developed, the lung damage is irreversible.
History and etymology
It was first described in 1946 by H L Hardy and I R Tabershaw.
Differential diagnosis
Radiographic and pathologic features are indistinguishable from pulmonary sarcoidosis 10. It may also not be possible to differentiate from other pneumoconioses.
See also
Quiz questions
References
- 1. Harris KM, McConnochie K, Adams H. The computed tomographic appearances in chronic berylliosis. Clin Radiol. 1993;47 (1): 26-31. Pubmed citation
- 2. Hansen M, Kauczor HU, Kelbel C et-al. [Chronic pulmonary berylliosis: imaging with high-resolution computerized tomography]. Aktuelle Radiol. 1995;5 (3): 149-51. Pubmed citation
- 3. Naccache JM, Marchand-Adam S, Kambouchner M et-al. Ground-glass computed tomography pattern in chronic beryllium disease: pathologic substratum and evolution. J Comput Assist Tomogr. 2003;27 (4): 496-500. Pubmed citation
- 4. Sood A. Current treatment of chronic beryllium disease. J Occup Environ Hyg. 2009;6 (12): 762-5. doi:10.1080/15459620903158698 - Free text at pubmed - Pubmed citation
- 5. Sharma N, Patel J, Mohammed TL. Chronic beryllium disease: computed tomographic findings. J Comput Assist Tomogr. 2010;34 (6): 945-8. doi:10.1097/RCT.0b013e3181ef214e - Pubmed citation
- 6. Newman LS, Buschman DL, Newell JD et-al. Beryllium disease: assessment with CT. Radiology. 1994;190 (3): 835-40. Pubmed citation
- 7. Aronchick JM. Chronic beryllium disease. Radiol. Clin. North Am. 1992;30 (6): 1209-17. Pubmed citation
- 8. Santo Tomas LH. Beryllium hypersensitivity and chronic beryllium lung disease. Curr Opin Pulm Med. 2009;15 (2): 165-9. doi:10.1097/MCP.0b013e3283218341 - Pubmed citation
- 9. Maier LA. Genetic and exposure risks for chronic beryllium disease. Clin. Chest Med. 2003;23 (4): 827-39. Pubmed citation
- 10. Hansell DM, Lynch DA, McAdams HP et-al. Imaging of Diseases of the Chest. Mosby. ISBN:0723434964. Read it at Google Books - Find it at Amazon
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