Name
BERYLLIOSIS
DESCRIPTION
DETAIL
CAUSE : BY EXPOSURE TO BERYLLIUM IN THE MANUFACTURING OF ALLOYS, CERAMICS, HIGH TECHNOLOGY ELCTRONICS & PRODUCTION OF FLUORESCENT LIGHTS, COMPUTER ELECTRONICS, AUTOMOTIVE ELECTRONICS.* PULMONARY FUNCTION TEST - RESTRICTIVE LUNG DISEASE OR NORMAL * CHEST X-RAY - HILAR LYMPHADENOPATHY &/OR INCREASED INTERSTITIAL MARKINGS * OPEN LUNG BIOPSY - GRANULOMATOUS FORMATION * TISSUE LEVELS OF BERYLLIUM IN LUNG - HIGH * Blood BeLPT currently is the test of choice to identify beryllium workers who develop beryllium sensitization or chronic beryllium disease (CBD). Blood BeLPT has an integral role in reaching a diagnosis of CBD. The test involves exposing peripheral blood mononuclear cells in vitro to beryllium salts at varying concentrations for variable time intervals. Cell proliferation in the presence of beryllium indicates a positive test result.
TYPENOTES
GENETIC PREDISPOSITION SEEMS TO HAVE A MAJOR ROLE IN DEVELOPMENT OF DISEASEMedical Care: " Prevention is a key component in the management of chronic beryllium disease (CBD). o The current Occupational Safety and Health Administration (OSHA) standards for workplace air require an 8-hour, time-weighted average maximum permissible level of 2 mcg/m3 along with a peak level of 25 mcg/m3. o The beryllium concentration in the air around factories is not to exceed 0.01 mcg/m3. o Some recent studies suggest that the current standard of 2 mcg/m3 is not protective. o Although no proof exists that cessation of exposure to beryllium improves the disease course or slows the progression, advising all patients with CBD to avoid any further exposure to beryllium is prudent. " Due to the use of BeLPT testing to screen workers exposed to beryllium, many cases now are diagnosed very early in the course of the disease, before radiographic or physiologic changes are observed and before symptoms or physical signs develop. " The natural history of the disease is not clear in patients who have granulomas on TBBX but who are asymptomatic and have no physiologic or radiographic abnormalities. " The current indications for therapy include the presence of symptoms, abnormal pulmonary function test results, or a decline in pulmonary function over time. In the absence of any of these criteria, no therapy is recommended. Close monitoring of symptoms and follow-up pulmonary function testing is recommended. " No controlled studies for CBD therapy are available. o Based on the pathogenesis of the disease (immune-mediated) and due to the similarities with sarcoidosis, CBD is treated with corticosteroids. o When corticosteroid therapy fails or in patients who develop significant adverse effects, methotrexate may be considered. Surgical Care: In end-stage cases, lung transplantation may be considered. DRUG TREATMENT : 1. CORTICOSTEROIDS - PREDNISONE 2. CYTOTOXIC AGENTS - METHOTREXATE
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
X-RAY CHEST P.A. VIEW( NORMAL ), COMPLETE BLOOD COUNT, PULMONARY FUNCTION TEST, CT SCAN THORAX, BIOPSY, BLOOD BE-LPT