Berylliosis is caused by exposure to fumes or finely divided dust of beryllium salts. Persons at risk are those working in the electronic, ceramic, aerospace and nuclear industry. Disease develops in about 2% of those exposed.
Acute berylliosis presents as an acute, toxic, exudative pneumonitis. The alveolar spaces are filled with a protein rich fluid. There are no granulomas. It usually resolves within a few weeks. About 5-10% progress to chronic berylliosis.
Chronic berylliosis is characterised by sarcoid-like, non-caseating peribronchial and perivascular granulomas. It is an example of a type IV hypersensitivity reaction. Similar granulomas may be found in the liver, kidney, skin and regional lymph nodes.
Presentation is with dyspnoea on exertion. Progressive fibrosis gradually leads to respiratory failure. Epidemiologic studies demonstrate a 2-fold increased risk of bronchogenic carcinoma.
Diagnosis is made on the basis of:
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