Epidemiology
- Risk Factors
- Electronics, Aerospace, Metal, and Ceramics Industry Employment: manufacture of alloys, ceramics, X-ray tubes, and vacuum tubes
- Household Exposure to Clothes of Spouse or Parent with Above Employment: increases risk of berylliosis
Physiology
- Immunologic reaction to beryllium
Pathology
- Granulomas (non-caseating): typically along lymphatic routes (possibly with associated cellular interstitial infiltration/ organizing pneumonia/UIP-type features)
Diagnosis
- Bronchoscopy: BAL lymphocytosis (>35%) may be seen (also seen in Sarcoid, LIP, HP, drug-induced, lymphoma)
- Normal BAL lymphocyte percentage: <15%
- Lymphocyte Transformation Test: BAL-obtained lymphocytes undergo transformation in presence of in vivo beryllium mineral (also can be done with blood lymphocytes, but this is less sensitive than test performed with BAL lymphocytes)
- CXR/Chest CT Patterns
- Interstitial Infiltrates (upper lobe-predominance):
- Mediastinal Lymphadenopathy:
- ACE Level: may be elevated (also may be elevated in Sarcoid, TB, Histo, Gaucher’s, DM, Leprosy, HIV, hepatitis)
Clinical
Acute Beryllium Disease
General Comments
- Single high-dose exposure can rarely produce airway and parenchymal lung disease
Acute Lung Injury-ARDS (see Acute Lung Injury-ARDS, [[Acute Lung Injury-ARDS]])
- Epidemiology
- Diagnosis
- Clinical
- Treatment
Chronic Beryllium Disease (Berylliosis)
General Comments
- Chronic exposure is most common, with exposure occurring over months-years
Sarcoidosis-Like Multisystem Disease
- Epidemiology
- Diagnosis
- Clinical
- Treatment
Treatment
References