| Idiopathic Pulmonary Fibrosis
| Diffuse Parenchymal Lung disease
| Asbestos Related Lung disease
| Coal Worker's Pneumoconiosis
| Cryptogenic Organising Pneumonia (COP-BOOP)
| Extrinsic Allergic alveolitis (Hypersensitivity)
| Cor Pulmonale
Causes a clinical picture similar to sarcoidosis
- Beryllium is a rare metal that has many applications
- It is lightweight, tensile strength, high melting point (1500°C)
- Aerospace industry, machinists, manufacture fluorescent lamps
- Those with HLA DPB1(Glu69) are more prone to chronic disease
- Acute exposure to beryllium leads to berylliosis with acute alveolitis with cough, progressive breathlessness, cyanosis and inspiratory crepitations and pulmonary oedema picture on CXR
- Chronic exposure leads to a hypersensitivity response with sarcoidosis like picture which can also affect close contacts e.g. wives. The disease may progress over months and years. Macular skin lesions are seen.
- CXR - fine reticulonodular shadowing for chronic disease. Pulmonary oedema picture for acute alveolitis.
- Biopsy shows a non-caseating granulomatous reaction Histologically indistinguishable from Sarcoidosis
- Pulmonary function testing - restrictive lung defect.
- Reduced transfer factor
- HRCT chest shows honeycomb lung and ground glass shadowing. Sarcoid like granulomas
- Acute disease - steroids can improve lung function
- Avoid further exposure and consider steroids in chronic exposure and disease
- Hypercalcaemia (seen with granulomata)