Beryllium

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

  • xxx

References

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