Document Detail


Short- and long-term response to corticosteroid therapy in chronic beryllium disease.
MedLine Citation:
PMID:  18757698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic beryllium disease (CBD) is a granulomatous disorder that affects the lung after exposure to beryllium. The present study reports short- and long-term evolution of granulomatous and fibrotic components in eight patients with severe CBD receiving corticosteroid therapy. Eight patients with confirmed CBD were studied at baseline, after initial corticosteroid treatment (4-12 months), at relapse and at the final visit. Beryllium exposure, Glu(69) (HLA-DPB1 genes coding for glutamate at position beta69) polymorphism, symptoms, pulmonary function tests (PFT), serum angiotensin-converting enzyme (SACE) and high-resolution computed tomography (HRCT) quantification of pulmonary lesions were analysed. The CBD patients were observed for a median (range) of 69 (20-180) months. After stopping beryllium exposure, corticosteroids improved symptoms and PFT (vital capacity +26%, diffusing capacity of the lung for carbon monoxide +15%), and decreased SACE level and active lesion HRCT score. In total, 18 clinical relapses occurred after the treatment was tapered and these were associated with SACE and active lesion HRCT score impairment. At the final visit, corticosteroids had completely stabilised all parameters including both HRCT scores of active lesions and fibrotic lesions in six out of eight patients. Corticosteroids were beneficial in chronic beryllium disease. They were effective in suppressing granulomatosis lesions in all cases and in stopping the evolution to pulmonary fibrosis in six out of eight patients.
Authors:
S Marchand-Adam; A El Khatib; F Guillon; M W Brauner; C Lamberto; V Lepage; J-M Naccache; D Valeyre
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European respiratory journal     Volume:  32     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-01     Completed Date:  2009-01-13     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  687-93     Citation Subset:  IM    
Affiliation:
Université Paris 13, EA2363, Assistance Publique-Hôpital de Pol's, Service de Pneumologie, Bobigny, France.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Adult
Berylliosis / complications,  drug therapy*,  immunology
Bronchoalveolar Lavage Fluid / cytology,  immunology*
Humans
Longitudinal Studies
Mass Screening*
Middle Aged
Pulmonary Fibrosis / etiology,  prevention & control*
Recovery of Function
Respiratory Function Tests
Retrospective Studies
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones
Comments/Corrections
Comment In:
Eur Respir J. 2008 Sep;32(3):543-4   [PMID:  18757694 ]

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