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Beryllium Disease

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A Clinical Guide to Occupational and Environmental Lung Diseases

Part of the book series: Respiratory Medicine ((RM))

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Abstract

Exposure to beryllium remains a significant occupational hazard, clinically resulting in berylliosis, or chronic beryllium disease (CBD). This scarring lung disease is an interstitial lung disease characterized by granulomatous inflammation that affects 2–10% of those exposed. Serving as a model for other granulomatous disease, CBD provides an example of an exposure-related disease that results from an environmental–genetic interaction. The development of CBD requires both a genetic predisposition, namely a major histocompatibility complex (MHC Class II) allele of HLA-DPB1 with a glutamic acid at amino acid position 69 (glu69), as well as exposure to beryllium.

The precursor to CBD, beryllium sensitization (BeS), is defined by the demonstration of a beryllium-specific cell-mediated immunity using the beryllium lymphocyte proliferation test (BeLPT), a test which provides clinicians the ability to differentiate CBD from similar granulomatous diseases. CBD is characterized by the presence of sensitized T-lymphocytes with Th1 cytokine production. Like many granulomatous diseases, CBD has a variable course, and although immunosuppressive drugs may be beneficial in some individuals, the disease has no cure. Thus, the focus on decreasing the prevalence of CBD relies on improving prevention in the workplace. This chapter will outline the potential for workplace exposure to beryllium as well as the immunopathogenesis, clinical manifestations, diagnosis, and current treatment of BeS and CBD.

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Authors and Affiliations

  1. Department of Medicine, Division of Environmental and Occupational Health Sciences, National Jewish Health, 1400 Jackson, Denver, CO, 80206, USA

    John Ferguson, Margaret M. Mroz & Lisa A. Maier

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  1. John Ferguson
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  2. Margaret M. Mroz
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  3. Lisa A. Maier
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Correspondence to Lisa A. Maier .

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Editors and Affiliations

  1. Division of Pulmonary, Allergy and, Critical Care Medicine, Duke University Medical Center, 330 Trent Drive, Hanes House, Rm 105-B, Durham, 27705, North Carolina, USA

    Yuh-Chin T. Huang

  2. , Human Studies Facility, Environmental Public Health Division, 104 Mason Farm Road, Chapel Hill, 27711, North Carolina, USA

    Andrew J. Ghio

  3. Department of Medicine, Division of Environmental and, National Jewish Health, 1400 Jackson, Denver, 80206, Colorado, USA

    Lisa A. Maier

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Ferguson, J., Mroz, M.M., Maier, L.A. (2012). Beryllium Disease. In: Huang, YC., Ghio, A., Maier, L. (eds) A Clinical Guide to Occupational and Environmental Lung Diseases. Respiratory Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-149-3_12

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