title: Search for chronic beryllium disease among sarcoidosis patients in Ontario, Canada.
abstract: Chronic beryllium disease (CBD) is clinically similar to other granulomatous diseases such as sarcoidosis. It is often misdiagnosed if a thorough occupational history is not taken. When appropriate, a beryllium lymphocyte proliferation tests (BeLPT) need to be performed. We aimed to search for CBD among currently diagnosed pulmonary sarcoidosis patients and to identify the occupations and exposures in Ontario leading to CBD. Questionnaire items included work history and details of possible exposure to beryllium. Participants who provided a history of previous work with metals underwent BeLPTs and an ELISPOT on the basis of having a higher pretest probability of CBD. Among 121 sarcoid patients enrolled, 87 (72%) reported no known previous metal dust or fume exposure, while 34 (28%) had metal exposure, including 17 (14%) with beryllium exposure at work or home. However, none of these 34 who underwent testing had positive test results. Self-reported exposure to beryllium or metals was relatively common in these patients with clinical sarcoidosis, but CBD was not confirmed using blood assays in this population.
authors.affiliation: Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada. marcos.ribeiro@utoronto.ca
authors.forename: Marcos
authors.initials: M
authors.lastname: Ribeiro
authors.forename: Leandro G
authors.initials: LG
authors.lastname: Fritscher
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Al-Musaed
authors.forename: Meyer S
authors.initials: MS
authors.lastname: Balter
authors.forename: Victor
authors.initials: V
authors.lastname: Hoffstein
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Mazer
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Maier
authors.forename: Gary M
authors.initials: GM
authors.lastname: Liss
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001607:Berylliosis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D001608:Beryllium / Q000009:adverse effects*; D049109:Cell Proliferation; D002478:Cells, Cultured; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000517:prevention & control*; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006801:Humans; D019570:Inhalation Exposure; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D009864:Ontario / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017565:Sarcoidosis, Pulmonary / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D001608:Beryllium