TY -的T1 -慢性铍病:azathioprine as a possible alternative to corticosteroid treatment JF - European Respiratory Journal JO - Eur Respir J SP - 234 LP - 236 DO - 10.1183/09031936.00095712 VL - 41 IS - 1 AU - Salvator, Hélène AU - Gille, Thomas AU - Hervé, Aurélie AU - Bron, Camille AU - Lamberto, Christine AU - Valeyre, Dominique Y1 - 2013/01/01 UR - //www.qdcxjkg.com/content/41/1/234.abstract N2 - To the Editor:Chronic beryllium disease (CBD) is a chronic granulomatous disease that mainly affects the lungs. It occurs after beryllium exposure in genetically susceptible individuals with, most commonly, the HLA-DPβ1 (Glu69) polymorphism [1]. Beryllium particles are slowly washed out, causing delayed onsets of the disease and flare ups long after exposure to beryllium [2, 3].The clinical, radiological and pathological presentation of CBD is very similar to sarcoidosis. Thus, misdiagnosis is not uncommon, as reported by Fireman et al. [4] and Müller-quernheim et al. [5]. These authors managed to correct the diagnosis of chronic sarcoidosis to CBD in 4–6% of patients, thanks to a careful retrospective screening for beryllium exposure [4, 5].In CBD, lungs are damaged by diffuse noncaseating granulomas and this may lead to fibrosis. The US Beryllium Case Registry determined the following specific criteria for CBD diagnosis: a beryllium exposure history; relevant clinical and radiological signs (breathlessness, reduced pulmonary capacity and diffuse interstitial opacities); evidence of beryllium sensitisation with positive beryllium lymphocyte proliferation test in blood or in bronchoalveolar lavage (BAL); and histopathological features such as noncaseating granulomas or mononuclear tissue infiltration without any infection. Long-term prognosis of CBD is poor with a mortality rate ranging from 5.8% … ER -