Proliferative response of bronchoalveolar lymphocytes to beryllium. A test for chronic beryllium disease.
OBJECTIVE
to ascertain whether measuring the proliferative response of bronchoalveolar lymphocytes to beryllium salts is useful for diagnosing chronic beryllium disease.


METHODS
prospective case series compared to normal volunteers and patients with sarcoidosis.


METHODS
university referral center.


METHODS
twenty-three consecutive beryllium workers were evaluated. Fourteen had chronic beryllium disease diagnosed on the basis of histologic evidence of a progressive pulmonary granulomatosis. Four had biopsy evidence of non-beryllium disease. Three had probable chronic beryllium disease but did not have lung biopsies. Two did not have biopsies and had basilar fibrosis on chest roentgenogram suggestive of non-beryllium lung disease. These patients were compared with 6 normal volunteers and 16 patients with sarcoidosis.


RESULTS
bronchoalveolar lavage was done and the proliferative response of the lung cells to two beryllium salts was tested. A positive proliferative test was defined as a stimulation index of more than five on two determinations. The sensitivity of this test was 100% in the 14 patients with definite chronic beryllium disease. The specificity of the test was also 100% among the normal volunteers and the 16 patients with sarcoidosis. The test was positive in none of the four patients with biopsy evidence of non-beryllium disease, none out of two patients with lower lobe fibrosis suggestive of non-beryllium disease, and all of three patients with probable chronic beryllium lung disease.


CONCLUSIONS
the proliferative response of bronchoalveolar lymphocytes to beryllium appears to be a useful test for chronic beryllium disease.
Rossman
M D
MD
Cardiovascular-Pulmonary Division, University of Pennsylvania, Philadelphia.
Kern
J A
JA
Elias
J A
JA
Cullen
M R
MR
Epstein
P E
PE
Preuss
O P
OP
Markham
T N
TN
Daniele
R P
RP
D001607:Berylliosis / Q000175:diagnosis* / Q000276:immunology; D001608:Beryllium; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D002455:Cell Division / Q000187:drug effects; D002908:Chronic Disease; D006801:Humans; D066298:In Vitro Techniques; D008214:Lymphocytes / Q000145:classification / Q000187:drug effects*; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012507:Sarcoidosis / Q000276:immunology; D012680:Sensitivity and Specificity
D001608:Beryllium