The current mainstay of management of chronic beryllium disease involves cessation of beryllium exposure and use of systemic corticosteroids. However, there are no randomized controlled trials to assess the effect of these interventions on the natural history of this disease. Despite this limitation, it is prudent to remove patients with chronic beryllium disease from further exposure and consider treating progressive disease early with long-term corticosteroids. The effect of treatment should be monitored using pulmonary function tests and high-resolution computed tomography of the chest. However, once pulmonary fibrosis has developed, corticosteroid therapy cannot reverse the damage.
Short-term effects of oral corticosteroids on high resolution computed tomography scans of eight…
FIGURE 1
Short-term effects of oral corticosteroids on high resolution computed tomography scans of eight chronic beryllium disease (CBD) patients. Panels a and b: A representative scan of a patient with CBD (a) before, and (b) during 4 months' steroid treatment. Diffuse ground-glass opacity with some micronodules are visible in (a) but these have disappeared in (b). Panels c and d: Quantification of lesions on scans of eight patients with CBD at baseline and after corticosteroid treatment (4-12 months). Panel c shows response to corticosteroids of opacities suggesting active inflammatory granulomatosis (ground-glass opacities, micronodules, and nodules); Panel d shows the response of fibrotic lesions (linear opacity, traction bronchiectasis, lobular distortion, bulla formation, cysts, and honeycombing) to corticosteroids. Reproduced with permission from European Respiratory Society Journals Ltd.(26)
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