DIFFERENTIAL-DIAGNOSIS OF BERYLLIOSIS SAR COIDOSIS IN A DENTAL TECHNICIAN/

History and clinical findings: Sarcoidosis was diagnosed in a dental t echnician when he was aged 21 years. Two years later prednisolone trea tment was started and continued for 14 years because of nonproductive cough with progressive reduction in vital capacity and CO transfer cap acity. Subsequently the risk of exposure to beryllium-containing dust in dental laboratories became known. In his case exposure had started before sarcoidosis had been diagnosed and had continued for 16 years. Changes typical of sarcoidosis (unproductive cough and dyspnoea; bihil ar lymphadenopathy and reticulonodular marking in the chest radiogram) were now present, at the age of 40 years. Investigations: Vital and d iffusion capacities were diminished, serum levels of angiotensin-conve rting enzyme (141 U/l) and of neopterin (5.8 mg/l) were increased. Ber yllium-lymphocyte transformation test of peripheral mononuclear cells after invitro culture with beryllium sulphate gave a raised stimulatio n index, and the intracutaneous beryllium sensitisation test was posit ive. This indicated sensitisation to beryllium even 9 years after expo sure had ceased. Conclusion: Even after exposure to beryllium has ende d, proof of exposure together with clinical and radiological findings typical of sarcoidosis and beryllium sensitisation can provide the dia gnosis of berylliosis.