[Chronic Beryllium disease after exposure to low-beryllium-content copper]

A 24-year-old man was admitted to our hospital because of exertional dyspnea and abnormal shadows on chest X-ray film. He worked in a factory, where he was exposed to 1.8% beryllium-copper alloys. His job was to draw out heated beryllium-copper wire to make it more fine. Chest X-ray film and chest CT scan showed left-sided pneumothorax, diffuse fine reticulonodular shadows, and several cysts. Pulmonary-function tests showed a restrictive disorder and a low diffusing capacity. A specimen obtained by open-lung biopsy showed epithelioid cell granuloma and alveolitis, which were compatible with chronic beryllium disease. The beryllium content of the lung tissue was 0.045 microgram/gram. Beryllium lymphocyte transformation tests on blood and on bronchoalveolar lavage fluid were positive. Based on these findings, chronic beryllium disease was diagnosed. After treatment with 1 mg/kg of prednisolone daily, dyspnea disappeared. Then the dose was tapered slowly. In Japan, chronic beryllium disease is extremely rare, and to our knowledge only 22 other cases have been reported.