A Case of Sarcoidosis with an Occupational History of a Low-level Beryllium Alloy

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A 48-year-old man was hospitalized with bilateral hilar lymphadenopathy and bilateral, upper predominant reticulonodular infiltrates on chest X-ray. However he had no respiratory symptoms. Lpithelioid cell granulomas were demonstrated by transbronchial lung biopsy as well as by biopsy of a subcutaneous nodule in his right leg. A diagnosis of sarcoidosis was considered. Nevertheless he had an occupational history of handling an alloy that contained a low level of less than 3% beryllium, which could cause chronic beryllium disease (CBD). Based on the negative results of beryllium lymphocyte proliferative tests (BeLPTs) using both his peripheral blood and bronchoalveolar lavage fluid, this case was finally diagnosed with sarcoidosis with an occupational history of a low-level beryllium alloy. Given the fact that low-level beryllium alloys are easily available without any restrictions in Japan, physicians who make a diagnosis of sarcoidosis should confirm a history of exposure to beryllium, especially use of those alloys and then exclude the possibilities of CBD by performing BeLPTs if the exposure to beryllium is under consideration.
日本サルコイドーシス/肉芽腫性疾患学会の論文