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Beryllium hypersensitivity and chronic beryllium lung disease

Santo Tomas, Linus H

Current Opinion in Pulmonary Medicine: March 2009 - Volume 15 - Issue 2 - p 165–169
doi: 10.1097/MCP.0b013e3283218341
Obstructive, occupational and environmental diseases: Edited by Basil Varkey
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Purpose of review This review aims to present the clinician with a synthesis of recent studies that have enhanced our understanding of the epidemiology and pathogenesis of beryllium hypersensitivity (BeH) and chronic beryllium disease (CBD).

Recent findings Lower occupational limit levels to beryllium exposure and more stringent preventive measures can decrease the risk for development of BeH and CBD. Beryllium sensitization is determined by a positive beryllium lymphocyte proliferation test (BeLPT). Longitudinal data suggest that BeH progresses to CBD. Together with a comprehensive history the BeLPT may help identify berylliosis in patients erroneously diagnosed to have sarcoidosis. HLA-DPB1-Glu69 marker is associated with increased susceptibility to development of BeH and CBD but poor positive predictive value limits its use; other genetic markers are being investigated. Recent investigations augment our understanding on the role of T-lymphocytes and chemokines in the pathogenesis of beryllium-associated disease. However, the basis for treatment strategies remains scarce.

Summary Our enhanced understanding of beryllium-associated lung disease potentially provides a window to unraveling other granulomatous diseases. However, even more questions beg to be elucidated and additional efforts are needed to translate this body of knowledge into better prevention and treatment.

Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

Correspondence to Linus H. Santo Tomas, MD, MS, Medical College of Wisconsin, Division of Pulmonary and Critical Care Medicine, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA Tel: +1 414 456 7040; fax: +414 456 6211; e-mail: lsantot@mcw.edu

© 2009 Lippincott Williams & Wilkins, Inc.