Diagnoses of chronic beryllium disease within cohorts of sarcoidosis patients

¹ Dept of Pneumology, Medical University Hospital Freiburg, Killianstraße 5, Freiburg 79106, Germany
² Dept of Pneumology, Medical University Hospital Freiburg, Killianstraße 5, Freiburg 79106, Germany; and Medical Hospital, Research Center Borstel 35 Parkallee, Borstel 23845, Germany
³ Dep. of Pulmonary and Allergic Diseases, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 64239, Israel

^* To whom correspondence should be addressed. E-mail: jmq{at}medizin.ukl.uni-freiburg.de.

	Abstract

An increase in chronic beryllium disease has been suggested due to higher industrial use of beryllium-alloys. Since occupational chronic beryllium disease is a perfect phenocopy of sarcoidosis it might be misdiagnosed as sarcoidosis.

We hypothesize that chronic beryllium disease exists in cohorts of sarcoidosis patients.

In a prospective case collection sarcoidosis patients were evaluated for potential beryllium exposure. In those patients in whom beryllium exposure was confirmed and beryllium hypersensitivity demonstrated the diagnosis sarcoidosis was rejected and corrected to chronic beryllium disease.

In 84 patients seen for reevaluating or making the diagnosis of sarcoidosis beryllium exposure was recognized and the diagnosis chronic beryllium disease was made in 34/84 patients. The time lag between clinical diagnosis of sarcoidosis and the final diagnosis of chronic beryllium disease ranged from 0 to 18 years (median: 3 years) and the mean age at time of diagnosis of chronic beryllium disease was 43.9 years (range: 25 to 80 years). beryllium-contaminated workplaces causing disease encompassed a wide spectrum of industries and technical trades in which beryllium-exposure is generally not perceived as a health hazard.

Chronic beryllium disease still belongs to the spectrum of differential diagnoses of granulomatous disorders.

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