Sarcoidosis

Chronic Berylliosis (CBD)

What is it?

An inflammatory disease that can affect any tissues of the body, resulting in microscopic lumps of inflammation called granulomas.

An occupationally acquired lung disease with abnormal formation of inflammatory masses or nodules (granulomas) within certain tissues and organs and widespread scarring and thickening of deep lung tissues.

When do the symptoms appear?

Sometimes symptoms are very specific.

Sometimes no symptoms appear at all.

 Sometimes symptoms appear and disappear suddenly

 Sometimes symptoms continue over a lifetime.

What are the symptoms?

Shortness of breath with a cough that will not go away (9 out of 10 cases have some type of lung problems)

Appearance of skin rashes or red bumps on the face, arms, or shins or inflammation of the fatty tissues under the skin on the legs, accompanied by arthritis in the ankles, elbows, wrists, and hands causing the skin to turn purple (20%) 

Eye diseases, such as inflammation of the eyes or enlarged tear ducts (20-30%) 

Sudden onset of symptoms like weight loss, fatigue, enlarged lymph nodes, night sweats, fever and an overall feeling of being ill.

Shortness of breath with a cough that will not go away and difficult breathing, except in upright position

 Appearance of skin rashes or red bumps on the face, neck, arms, hands shins or skin or purple skin

Corneal lesions

Weight loss, fatigue, fever or enlarged nymph nodes

What are the causes?

Caused by a variety of biologic, chemical or physical irritants.

Only caused by exposure to beryllium, primarily by inhalation and contact through broken skin in individuals who are sensitive to beryllium.

Is it rare?

No, sarcoidosis is a common chronic illness that appears all over the world.

Yes but, it is estimated that 2–6% of workers exposed to these contaminants eventually develop berylliosis.

Who can get it?

Anyone can contract the disease. But the figures below are probably underestimated because it is difficult to diagnose:

5 in 100,000 Caucasian Americans

40 out of 100,000 African Americans

64 out of 100,000 people in Scandinavian countries

It seems to appear most in people between the ages of 20 and 40 years, rarely developing under age 10 or over 60.

These ‘outside’ age groups most often have the milder form of the disease.

Risk is greatest among young black woman, two times more likely than a black man. (Often getting the more chronic and severe form of the disease)

Risk is greatest among young women of Scandinavian, German, Irish or Puerto Rican origin.

Caucasian men are just as likely to get the disease as women

Only those people who have been exposed to and have sensitivity towards the toxic metal beryllium.

1-16% of exposed workers develop beryllium hypersensitivity and a portion develop CBD

Cases of people with very low exposure in a plant who are not involved with the processing are known to get the disease

The figures below are probably underestimated because of how few doctors perform the diagnostic tests.

134,000 to 800,000 current and former workers in the United States have been exposed to beryllium.

Up to 6 percent of all patients diagnosed with sarcoidosis may actually have CBD - among patients diagnosed with sarcoidosis in whom beryllium exposure can be confirmed, as many as 40 percent may actually have CBD.

Is it easy to diagnose?

No, it can easily be mistaken for another disease, or overlooked completely by a doctor.

How is it diagnosed?

Doctors first look at a patient’s medical history, and performs routine tests during a physical exam. They should take into consideration the presenting symptoms, patient’s age, race and ethnic group and contaminant exposure.

What is the doctor looking for?

Nodular inflammation around tissues of the lungs and nymph nodes, but can appear as a skin eruptions or eye disease. Other organs that can be affected (in this order) are the liver, skin, heart, nervous system and kidneys.

Enlargement of the salivary or tear glands or cysts in bone tissues are often indicators of the disease.

Nodular inflammation and fibrosis around tissues of the lungs, but can appear in other organs (liver) and tissues (skin).

What tests does a doctor perform?

Chest X-ray
Pulmonary test

Chest X-ray
Pulmonary test
Lung Biopsy
Beryllium Lymphocyte Proliferation Test (BeLPT) 

Who can perform these tests?

Any doctor

BeLPT is only performed in selected specialized laboratories, including the following:

Center for Epidemiologic Research
Oak Ridge Institute for Science and Education (Former Beryllium Worker Medical Surveillance Program)
ORISE/CER, P.O. Box 117
Oak Ridge, TN 27831-0117
(865) 576-3115
(865) 241-6152
FAX (865) 241-2923

Cleveland Clinic Foundation
9500 Euclid Avenue
Cleveland, OH 44195-0001
(216) 444-2200
(216) 444-8844
(800) CCF-CARE (223-2273) ext 48844 or 55763

Hospital of the University of Pennsylvania
Pulmonary Immunology Laboratory
815 East Gates Building, 4300 Spruce Street
Philadelphia, PA 19104-4283

National Jewish Center for Immunology and Respiratory Medicine
Cellular Immunology Tests
Pulmonary Division and Occupational/Environmental Medicine Division
1400 Jackson Street
Denver, CO 80206
(303) 388-4461

Specialty Laboratories, Inc.
OncQuest
2211 Michigan Avenue
Santa Monica, CA 90404-3900
(310) 828-6543 or (800) 421-4449

When is it confirmed?

The disease is confirmed by eliminating other diseases.

The evidence of sensitization to beryllium by positive findings in blood or bronchoalveolar lavage resulting from a beryllium lymphocyte proliferation test (BeLPT)

AND

the presence of lung granulomas from a lung biopsy