Beryllium disease (sometimes called berylliosis) is a lung inflammation caused by inhaling dust or fumes that contain beryllium.
In the past, beryllium was commonly mined and extracted for use in the electronics and chemical industries and in the manufacture of fluorescent light bulbs. Today, it is used mainly in the aerospace industry and in beryllium–aluminum castings. Besides workers in these industries, a few people living near beryllium refineries also have developed beryllium disease.
Beryllium disease differs from other environmental lung diseases in that at low levels of exposure, lung problems seem to occur only in people who are sensitive to beryllium—about 2 to 6% of those who come in contact with it. The disease can occur in such people even with a relatively brief exposure to beryllium dust.
Symptoms and Diagnosis
In some people, beryllium disease develops suddenly (acute beryllium disease), mainly as an inflammation of the lungs (pneumonitis). In these people, the lungs are stiff and function poorly. People with acute disease have an abrupt onset of coughing, difficulty in breathing, and weight loss. Acute beryllium disease also can affect the skin and eyes. This form of beryllium disease is now rare.
More commonly, people develop chronic beryllium disease, in which abnormal tissue forms in the lungs and the lymph nodes enlarge. In these people, coughing, difficulty breathing, weight loss, night sweats, and fatigue develop gradually, often 10 to 20 years after exposure. When detected early, people may initially have no symptoms.
The diagnosis is based on the person's history of exposure to beryllium and on results of a blood test, called the beryllium lymphocyte proliferation test (BeLPT), which tests for allergy to beryllium. If the disease is at a more advanced stage, characteristic changes on a chest x-ray or computed tomography (CT) helps doctors make the diagnosis. However, x-rays and CT scans of people with beryllium disease resemble those of people with sarcoidosis (another lung disease—see see Sarcoidosis). Definitive diagnosis is made by doing a test in which a tube, called a bronchoscope, is inserted into the lungs to obtain pieces of lung tissue and cells to test for an allergic reaction to beryllium.
Prognosis, Prevention, and Treatment
Acute beryllium disease may be severe. Most people recover in 7 to 10 days, with appropriate treatment, such as ventilator support and corticosteroid drugs. However, some people with severe acute disease die or develop chronic beryllium disease.
The course of people who develop symptoms years after exposure is completely different. People with chronic beryllium disease continue to have symptoms, which tend to progress. If the lungs are severely damaged, the heart may become strained, causing a type of heart failure (cor pulmonale—see see Sidebar 1: Cor Pulmonale: A Disorder Stemming From Pulmonary Hypertension) and death. Sometimes corticosteroids, such as oral prednisone, are prescribed for chronic beryllium disease. Some people need to take corticosteroids for the rest of their lives. In some people with very severe chronic beryllium disease, lung transplantation can be life saving. Other supportive measures, such as supplemental oxygen therapy, pulmonary rehabilitation, and drugs for treatment of right-sided heart failure, are used as needed.
Beryllium disease can be prevented by strictly limiting exposure to beryllium.
Last full review/revision April 2008 by Lee S. Newman, MD, MA