Searching PubMed for Chronic Beryllium Disease

You can search for medical journal articles on PubMed which has millions of entries.  Using the search term chronic beryllium diesease there are 407 articles.  You can narrow down the articles by adding further search terms like prognosis, treatment, or genetic susceptibility, and you can also use the LIMITS page to narrow it down to only English language articles or ones that you can read the full article online for free.  For instance, searching English only, humans only, free articles online and only articles with abstracts (summaries) narrows it down to 71 articles, 12 of which are review articles.  The full articles can be read by going to PubMed and searching by the PMID number or in many other ways.  Then click on the link that says FULL TEXT.

Below are examples of abstracts of review articles from PubMed.

1:  Environ Health Perspect. 2000 Aug; 108 Suppl 4:685-96.
Inorganic dust pneumonias:  the metal-related parenchymal disorders.  Kelleher P, Pacheco K, Newman LS.
Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Medical and Research Center, Denver, Colorado 80206, USA.

In recent years the greatest progress in our understanding of pneumoconioses, other than those produced by asbestos, silica, and coal, has been in the arena of metal-induced parenchymal lung disorders. Inhalation of metal dusts and fumes can induce a wide range of lung pathology, including airways disorders, cancer, and parenchymal diseases. The emphasis of this update is on parenchymal diseases caused by metal inhalation, including granulomatous disease, giant cell interstitial pneumonitis, chemical pneumonitis, and interstitial fibrosis, among others. The clinical characteristics, epidemiology, and pathogenesis of disorders arising from exposure to aluminum, beryllium, cadmium, cobalt, copper, iron, mercury, and nickel are presented in detail. Metal fume fever, an inhalation fever syndrome attributed to exposure to a number of metals, is also discussed. Advances in our knowledge of antigen-specific immunologic reactions in the lung are particularly evident in disorders secondary to beryllium and nickel exposure, where immunologic mechanisms have been well characterized. For example, current evidence suggests that beryllium acts as an antigen, or hapten, and is presented by antigen-presenting cells to CD4+ T cells, which possess specific surface antigen receptors. Other metals such as cadmium and mercury induce nonspecific damage, probably by initiating production of reactive oxygen species. Additionally, genetic susceptibility markers associated with increased risk have been identified in some metal-related diseases such as chronic beryllium disease and hard metal disease. Future research needs include development of biologic markers of metal-induced immunologic disease, detailed characterization of human exposure, examination of gene alleles that might confer risk, and association of exposure data with that of genetic susceptibility.

PMID: 10931787 [PubMed - indexed for MEDLINE]
PMCID: PMC1637664
 

2:  Environ Health Perspect. 1996 Oct; 104 Suppl 5:945-7.
Chronic beryllium disease:  diagnosis and management.  Rossman MD.
Pulmonary and Critical Care Division, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA. rossmanm@mail.med.upenn.edu

Chronic beryllium disease is predominantly a pulmonary granulomatosis that was originally described in 1946. Symptoms usually include dyspnea and cough. Fever, anorexia, and weight loss are common. Skin lesions are the most common extrathoracic manifestation. Granulomatous hepatitis, hypercalcemia, and kidney stones can also occur. Radiographic and physiologic abnormalities are similar to those in sarcoidosis. While traditionally the pathologic changes included granulomas and cellular interstitial changes, the hallmark of the disease today is the well-formed granuloma. Immunologic studies have demonstrated a cell-mediated response to beryllium that is due to an accumulation of CD4+ T cells at the site of disease activity. Diagnosis depends on the demonstration of pathologic changes (i.e., granuloma) and evidence that the granuloma was caused by a hypersensitivity to beryllium (i.e., positive lung proliferative response to beryllium). Using these criteria, the diagnosis of chronic beryllium disease can now be made before the onset of clinical symptoms. Whether, with early diagnosis, the natural course of this condition will be the same as when it was traditionally diagnosed is not known. Currently, corticosteroids are used to treat patients with significant symptoms or evidence of progressive disease.

PMID: 8933039 [PubMed - indexed for MEDLINE]
PMCID: PMC1469698

3. Environ Health Perspect. 1996 Oct; 104 Suppl 5:937-43.

The natural history of beryllium sensitization and chronic beryllium disease.  Newman LS, Lloyd J, Daniloff E.
Departmet of Medicine, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206, USA. newmanl@njc.org

With the advent of in vitro immunologic testing, we can now detect exposed individuals who are sensitized to beryllium and those who have chronic beryllium disease (CBD) with lung pathology and impairment. Earlier detection and more accurate diagnostic tools raise new questions about the natural history of sensitization and granulomatous disease. Preliminary data suggest that early detection identifies people who are sensitized to beryllium and that these individuals are at risk for progressing into clinical disease. This article discusses the historical, recent, and ongoing studies germane to our understanding of CBD natural history, including the immunologic and inflammatory basis of the disease, the environmental and host risk factors for disease progression, biological markers of disease severity and activity that may help predict outcome, and the implications for broad-based workplace screening to identify patients at the earliest stages of beryllium sensitization and disease.

PMID: 8933038 [PubMed - indexed for MEDLINE]
PMCID: PMC1469683

4. Environ Health Perspect. 1981 Aug; 40:101-5.

The carcinogenicity of beryllium.  Kuschner M.
Beryllium, some of its alloys, and a variety of its compounds have induced malignant tumors of the lung and osteogenic sarcoma in experimental animals. Three animal species, monkeys, rabbits, and rats, have been shown to be susceptible. Beryllium induces morphological transformation in mammalian cells and enhances viral transformation of mammalian cells. It has been shown to decrease fidelity of DNA synthesis. It has been recognized that exposure to compounds of this metal will, in some individuals, result in a chronic granulomatous disease of the lung. A series of overlapping recent human epidemiological studies have been suggestive of an increase in the incidence of lung cancer in populations occupationally exposed to beryllium. Such studies, together with animal and in vitro studies, argue for the strong presumption of a carcinogenic hazard to man in occupational beryllium exposures.

PMID: 7023926 [PubMed - indexed for MEDLINE]
PMCID: PMC1568815