Ca. Bobka et al., COMPARISON OF IN-VIVO AND IN-VITRO MEASURES OF BERYLLIUM SENSITIZATION, Journal of occupational and environmental medicine, 39(6), 1997, pp. 540-547
Chronic beryllium disease (CBD) diagnosis hinges on demonstrating a ce
ll-mediated immune response to beryllium slats in vitro with the beryl
lium lymphocyte proliferation test (BeLPT). The BeLPT has found widesp
read application in screening for CBD and beryllium sensitization in p
opulations of exposed workers. We hypothesized that the in vivo beryll
ium salt patch test may be of value as an adjunct to the BeLPT, rectif
ying false negative or ambiguous blood test results, We studied subjec
ts with CBD (n = 11), beryllium sensitization without disease (n = 3),
and control subjects with dermatitis (n = 20), Evaluation included co
mpetition of a demographic questionnaire, blood BeLPT (if CBD or beryl
lium-sensitized), and beryllium patch testing with 0.1% and 1% berylli
um sulfate (BeSO4) in petrolatum and in aqueous vehicles, Biopsies wer
e performed at abnormal patch test sites in five subjects, The 1% aque
ous BeSO4 proved superior either to 1% petrolatum or 0.1% solutions, p
roducing positive reactions in all CBD and beryllium-sensitized subjec
ts. We observed no long-term adverse reactions. Biopsies demonstrated
spongiotic changes early, followed by noncaseating granulomas within 2
8 days, We conclude that the beryllium patch test can be used safely t
o clarify the sensitization state and diagnosis of CBD.