Document gDMBnepZ2O801QdnZX21dMXm3

<- >1 i', SPONTANEOUS REMISSION OF CHRONIC BERYLLIUM POISONING FROM FLUORESCENT LAMP MANUFACTURING Report of a Case JOHN W. CASS Jr., M.D. BROOKLINE, MASS. THIS IS a case of chronic beryllium poisoning with spontaneous recovery. I urge that considerable caution be used as regards the evaluation of any specific therapy for this disease at the present time. The patient was first seen on Jan. 7, 1943, at the age of 25 years. He gave a history of having noticed shortness of breath, loss of weight and increased general weakness over a period of approximately 12 months. After roentgenograms of the chest had been obtained, he was referred to the Massachusetts General Hospital. A brief period of study revealed no definite diagnosis, and he was discharged with the questionable diagnosis of sarcoid. No specific treat ment was instituted. Shortly after this, it was discovered that several persons showing similar clinical syndromes were present where this man was employed, and at the request of the insurance company concerned he was readmitted to the hospital for a more complete study. Further inquiry regarding the history revealed that there was no evidence of any industrial hazard prior to this patient's being employed by a fluorescent lamp manufacturing company early in 1941. While employed with this company, he worked at a desk in the department where imperfect tubes were reclaimed, and there was a definite dust hazard present. He worked under these conditions for about six months. He felt well for an additional six months, so that his symptoms began about one year after he obtained employment with this company. An extensive study was undertaken in the hospital, but there were few positive findings. The-vital capacity was low. The tuberculin test was negative. Roentgenograms showed no change as compared with the original ones and simply suggested a diffuse miliary granulomatous reaction in the lungs. On one occasion the blood calcium was reported as being rather high. Again no diagnosis was made, but it was definitely recognized that this man had a clinical syndrome similar to those presented by several other employees of this company and that the problem was unquestionably an occupational poisoning of some type, probably beryllium. After being discharged from the hospital, the patient remained completely disabled and rather acutely ill for six or seven months. The predominant symptoms were shortness of breath and general debility. His weight was maintained at about 110 lb. (50 Kg.), whereas his normal weight was approximately 145 lb. (65 Kg.). During this period of six or seven months he had one episode of prolonged, unex plained diarrhea, which was quite alarming but which finally responded to general symptomatic therapy. On another occasion he had a series of nasal hemorrhages so severe that hospitalization and transfusions were required. He was confined to his bed or chair for most of this period. His sense of well-being finally began, to improve. He was able to eat. At the end of approxi mately eight months he was well enough to bo back to part-time work. Approximately one year after the onset of his acute illness he was able to return to full-time work and has continued to follow a fairly normal program since. At the present time he weighs 147 lb. (66.5 Kg.) and * , V/ # _ Read at a meeting sponsored by the Occupational Medical Clinic at the Massachusetts General Hospital, Boston, Dec. 13, 1950. 569 i 4 it ,it