Medication Summary
Corticosteroids are the treatment of choice for chronic beryllium disease (CBD). No consensus on the dose or duration of corticosteroid therapy exists. A starting dose of 20-40 mg of oral prednisone daily or every other day usually is used. After an initial 4-6 weeks of therapy, prednisone is tapered, depending on the clinical response.
MTX may be considered in patients who do not respond to corticosteroids or in patients who develop significant adverse effects on corticosteroid therapy.
Corticosteroids
Class Summary
Have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.
Prednisone (Sterapred)
Immunosuppressant for treatment of autoimmune disorders. May decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and also suppresses lymphocytes and antibody production. A 3-phase approach is suggested.
Cytotoxic agents
Class Summary
Inhibit cell growth and proliferation, which decreases immune system activity.
Methotrexate (Folex PFS, Rheumatrex)
Unknown mechanism of action in treatment of inflammatory reactions. May affect immune function. Ameliorates symptoms of inflammation (eg, pain, swelling, stiffness). Adjust dose gradually to attain satisfactory response.
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A high-resolution CT scan of the chest showing the typical ground glass appearance in a patient with chronic beryllium disease, or berylliosis.
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A histopathology slide (hematosin and eosin stain) showing the typical well-formed granuloma of chronic beryllium disease, or berylliosis.