Treatment of Beryllium Sensitization and Chronic Beryllium Disease
Beryllium Sensitization
Chronic Beryllium Disease
Beryllium Sensitization
Is beryllium sensitization treated?
Beryllium sensitization is a condition that is not treated with any medications. The only symptom of sensitization is an abnormal BeLPT, performed either on blood cells or on lung cells collected during bronchoscopy. Currently, there is no medication or procedure available to eliminate this “allergic” reaction to beryllium.
Can beryllium sensitization be cured?
At the present time, there is not a known cure for beryllium sensitization.
What are my chances of developing CBD?
When people with beryllium sensitization undergo clinical evaluation to determine if they have CBD, between 20% and 100% of them are found to have this illness on their first evaluation. If you have undergone evaluation and are found to have beryllium sensitization at the current time, you are still at significant risk for developing CBD in the future. Recent research suggests that each year, 6% to 8% of people with beryllium sensitization will develop CBD 1.
How often should I see my doctor?
People with beryllium sensitization should see their physician at least every 2 years. At that time, they should have pulmonary function tests and exercise tolerance tests to see if their lungs are having difficulty exchanging oxygen and carbon dioxide with the bloodstream, a chest x-ray or CT scan to check for scarring in the lungs, and a bronchoscopy with lavage and biopsy to see if they have developed granulomas or other abnormalities in their lungs. The types of testing you will need may be different based on your overall health. If you develop symptoms of CBD, such as a dry cough or unexplained shortness of breath, you should see your physician sooner!
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Chronic Beryllium Disease
Can CBD be cured?
At the present time, there is not a known cure for CBD. However, with close monitoring and treatment by your physician, the disease can be slowed down. National Jewish and other research institutions in the U.S. and abroad are studying the mechanisms of CBD to better understand how the disease works and the complicated biological processes involved. Eventually, this understanding may lead to better treatments for CBD, if not a complete cure.
Will I need treatment for CBD?
Not everyone who has CBD will need treatment, and the course of the disease is different for each individual. Many patients will eventually need treatment though, and the type of treatment you require will depend on the severity of your disease. In general, the goals of treatment for CBD are to improve your symptoms, to protect your lungs from further damage caused by scarring, and to improve the oxygen levels in your bloodstream. At National Jewish, our goal is to help you maintain your normal lifestyle as much as possible, so that you can continue to enjoy the people and activities that are important to you.
If your CBD is diagnosed in early stages, your lungs may function normally and you may not notice any symptoms of illness. As the disease progresses, you may begin notice airways symptoms, such as dry cough or wheezing, that may be similar to asthma. Your physician may prescribe an inhaled steroid to manage your symptoms (for more information on inhaled steroids, please see the Inhaled Steroids. As your disease progresses, you may note that your symptoms are worsening, or your physician may detect abnormalities in your gas exchange (the ability of your lungs to exchange oxygen for carbon dioxide in the bloodstream). At that time, you may need an immunosuppressive medication, such as prednisone. Individuals with more advanced disease may also require supplemental oxygen. Find out more information on oxygen therapy.
Will I need to take prednisone for my CBD?
If an individual with CBD requires medication to improve symptoms and lung function, the drug most commonly prescribed is prednisone. Immunosuppressive medications such as prednisone slow the immune system’s response to the beryllium in your lungs, and generally help decrease symptoms while improving gas exchange between the lungs and bloodstream. Typically patients are given a course of prednisone that is gradually decreased (tapered) over a period of time. Long-term use of prednisone does have side effects, and you should discuss the risks and benefits of prednisone use with your physician before beginning treatment. Find out more information on the risks and benefits of steroid treatment.
Are there other medications that can be used to treat CBD?
Other immunosuppressive drugs have been used along with prednisone to treat CBD. These medications can also be used alone if a patient does not respond to prednisone or cannot tolerate the side effects. Currently National Jewish is conducting a clinical trial of a new medication. This medication has been used to successfully treat other immune system diseases and looks promising in the treatment of CBD.
How often should I see my doctor?
In general, patients with CBD should see their physician at least once a year. At that time, they should have pulmonary function tests and exercise tolerance tests to see if their lungs are having difficulty exchanging oxygen and carbon dioxide with the bloodstream, and a chest x-ray or CT scan to check for scarring in the lungs. The types of testing you will need may be different based on your overall health, the course of your disease, and whether or not you are on immunosuppressive medications, such as prednisone. Patients with more advanced disease, or with worsening symptoms, should see a physician more frequently. You should talk with your physician about how frequently you should be seen.
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References
- Newman LS, Mroz MM, Balkisoon RC, Maier LA. Beryllium sensitization progresses to chronic beryllium disease: a longitudinal study of disease risk. Am J Respir Crit Care Med 2004; published ahead of print on September 16, 2004 as doi:10.1164/rccm.200402-190OC.
