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  • Reviewed on 5/11
    By Dr. Maier et al.

Chronic Beryllium Disease: Diagnosis


How do I know if I have CBD?

Diagnosis of CBD begins with a beryllium lymphocyte proliferation test (BeLPT). The BeLPT is a test that helps determine if your immune system reacts to beryllium as a foreign substance -- this reaction creates abnormal BeLPT results. In individuals who do not have beryllium sensitization or CBD the immune system does not respond to beryllium in any manner, which produces normal BeLPT results. 

Individuals with two or more abnormal BeLPT results are considered to have “confirmed beryllium sensitization” and are encouraged to undergo further evaluation to determine if they have CBD. Individuals with other combinations of non-normal test results, such as an abnormal and a borderline BeLPT, may also be candidates for further evaluation. This medical evaluation typically includes an appointment with a physician familiar with the health effects of beryllium, exercise tolerance testing, pulmonary function testing, a chest x-ray or CT scan, blood work, and diagnostic bronchoscopy with biopsy and lavage (lung washing). The types of testing your physician performs may differ based on your overall health. Based on the results of the tests, your physician will likely be able to determine if you have CBD. 

The diagnosis is typically made on the basis of confirmed beryllium sensitization and the finding of abnormal collections of cells called granulomas, or by an abnormal beryllium test in the immune cells from the lungs and significantly elevated number of a particular type of an immune cell called a lymphocyte. 

 

What is a beryllium lymphocyte proliferation test (BeLPT)?

The beryllium lymphocyte proliferation test (BeLPT) is a test that measures beryllium sensitization, which is the immune system’s reaction to beryllium.

More information on the BeLPT.

 

For more information on beryllium, please contact National Jewish Health® at 1.800.222.5864.

 

References

  1. Mroz MM, Balkissoon R, Newman LS. Beryllium. In: Bringham E, Cohrssen B, Powell C (eds.) Patty’s Toxicology, Fifth Edition. New York: John Wiley & Sons 2001, 177-220.
  2. Balkissoon RC, Newman LS. Beryllium cooper alloy (2%) causes chronic beryllium disease. J Occup Environ Med 1999; 41: 304-308.
  3. Kreiss K, Mroz MM, Ahen B, Martyny JW, Newman LS. Epidemiology of beryllium sensitizations and disease in nuclear workers. Am Rev Respir Dis 1993; 148:985-991.
  4. Newman LS, Kreiss K. Non-occupational chronic beryllium disease masquerading as sarcoidosis: Identification by blood lymphocyte proliferative response to beryllium. Am Rev Respir Dis 1992; 145:1212-1214.
  5. Steenland K, Ward E. Lung Cancer Incidence Among Patients with Beryllium Disease: a Cohort Mortality Study. J Natl Cancer Inst 1991; 83:1380-1385.
  6. Kriebel D, et al. The pulmonary toxicity of beryllium. Am Rev Respir Dis 1988; 137: 464-473.
  7. Kreiss K, Newman LA, Mroz M, Campbell PA. Screening blood test identifies subclinical beryllium disease. J Occ Med 1989; 31:603-608.
  8. Kreiss K, Wasserman S, Mroz MM, Newman LS. Beryllium disease screening in ceramics industry: Blood test performance and exposure-disease relations. J Occup Med 1993; 35: 267-274.
  9. Kreiss K, Mroz MM, Newman LS, Martyny J, Zhen B. Machining risk of beryllium disease and sensitization with median exposures below 2 µg/m3. Am J Indust Med 1996; 30:16-25.
  10. Kreiss K, et al. Risks of beryllium disease related to work processes at a metal, alloy and oxide production plant. Occup Environ Med 1997; 54:605-612.
  11. Mroz MM, Kreiss K, Lezotte DC, Campbell PA, Newman LS. Re-examination of the blood lymphocyte transformation test in the diagnosis of chronic beryllium disease.  J Allergy Clin Immunol 1991; 88:54-60.
  12. Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease: From the work place to cellular immunology, molecular immunogenetics, and back. Cl Immunol Immunopath 1994; 71:123-129.
  13. Rossman MD. Differential diagnosis of chronic beryllium disease. In: Rossman MD, Preuss OP, Powers MB, eds. Beryllium: Biomedical and Environmental Aspects. Baltimore: Williams & Wilkins, 1991; 167-175.
  14. Newman LS, Mroz MM, Maier LA, Danilof EM, Balkissoon R. Efficacy of serial medical surveillance for chronic beryllium disease in a beryllium machining plant. J Occup Environ Med 2001; 43:231-237.
  15. Yoshida T, Shima S, Nagoka K et al. A study on the beryllium Lymphocyte Transformation Test and the beryllium levels in working environment. Ind Health 1997; 35:374-379.
  16. Cullen M, et al. Chronic beryllium disease in a precious metal refinery: clinical, epidemiologic, and immunologic evidence for continuing risk from exposure to low-level beryllium fume, Am Rev Respir Dis 1987; 135:201-208.
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