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Occupational Medicine 53:223-227 (2003)
Copyright © 2003 Society of Occupational Medicine

Measurement of beryllium in lung tissue of a chronic beryllium disease case and cases with sarcoidosis

D. K. Verma1, A. C. Ritchie2 and M. L. Shaw1

1Program in Occupational Health and Environmental Medicine and the Occupational and Environmental Health Laboratory, McMaster University, Hamilton, Ontario, Canada.
2Department of Pathology, University of Toronto, Toronto, Ontario, Canada.

Correspondence to: Dave K. Verma, Program in Occupational Health and Environmental Medicine, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. e-mail: vermadk{at}mcmaster.ca

Abstract

Background The clinical features of chronic beryllium disease (CBD) are similar to many other chronic lung diseases. In particular, it may be difficult to distinguish it from pulmonary sarcoidosis since the two conditions may be very alike in clinical, pathological and radiological features.

Aim To determine if the amount of beryllium found in the lungs could be used to differentiate CBD from sarcoidosis and controls.

Methods Analyses for beryllium in the autopsied lung tissues of 29 cases and controls were carried out. The cases included one CBD, three confirmed sarcoidosis and 25 controls. Blocks of formalin-fixed tissues were analysed by an atomic absorption spectrophotometer equipped with a graphite furnace. A method for analysis of beryllium in air was modified to permit tissue analysis.

Results The CBD case had a much higher average beryllium level, but some individual results were similar to controls and patients with sarcoidosis.

Conclusion The CBD case had beryllium levels within the range of values reported in the literature. The differentiation between CBD and sarcoidosis could not be made with reasonable assurance based only on the analytic result. Occupational history is very important in making a diagnosis of CBD, along with the analysis of tissues. Tissue analysis helped confirm the diagnosis of compensatable CBD in this particular case.

Keywords      Autopsy lungs; berylliosis; beryllium; beryllium analysis; chronic beryllium disease; occupational exposure; sarcoidosis


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