{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:25:32Z","timestamp":1787502332333,"version":"build-2736575974"},"reference-count":12,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021729","name":"Medizinische Fakult\u00e4t der Albert-Ludwigs-Universit\u00e4t Freiburg","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100021729","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,7,10]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Systemic involvement in chronic beryllium disease (CBD) has been reported only anecdotally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe a case series of six patients with CBD demonstrating systemic involvement across diverse occupational settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients had documented occupational beryllium exposure. CBD diagnosis was confirmed by positive histology and lymphocyte proliferation test in all cases. All patients presented with signs of extrapulmonary organ involvement, including hepatic, gastric, neurologic, splenic, ocular, cutaneous, as well as possible cardiac and renal involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This series underscores the importance of including CBD in the differential diagnosis of sarcoidosis in workers with possible beryllium exposure, even in the presence of extrapulmonary manifestations. Clinicians should maintain awareness of extrapulmonary involvement in patients with CBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2025-110668","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:20:20Z","timestamp":1785432020000},"page":"283-286","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic chronic beryllium disease: beyond lung disease"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-5557","authenticated-orcid":false,"given":"Louis","family":"Jouanjan","sequence":"first","affiliation":[{"name":"Department of Pneumology, Medical Center - University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Zissel","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Medical Center - University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prerana","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Stolz","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Medical Center - University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn Christian","family":"Frye","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Medical Center - University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026082308400580000_83.5.283.1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1055\/s-0034-1377059","article-title":"Sarcoidosis and chronic beryllium disease: similarities and differences","volume":"35","author":"Mayer","year":"2014","journal-title":"Semin Respir Crit Care Med"},{"key":"2026082308400580000_83.5.283.2","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00991-2017","article-title":"Phenotypes of organ involvement in sarcoidosis","volume":"51","author":"Schupp","year":"2018","journal-title":"Eur Respir J"},{"key":"2026082308400580000_83.5.283.3","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.chest.2025.06.034","article-title":"Beryllium Lymphocyte Proliferation Test: Differential Diagnosis of Sarcoidosis and Chronic Beryllium Disease","volume":"168","author":"Jouanjan","year":"2025","journal-title":"Chest"},{"key":"2026082308400580000_83.5.283.4","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201409-1722ST"},{"key":"2026082308400580000_83.5.283.5","first-page":"19","article-title":"The WASOG Sarcoidosis Organ Assessment Instrument: An update of a previous clinical tool","volume":"31","author":"Judson","year":"2014","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"key":"2026082308400580000_83.5.283.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(69)90074-6"},{"key":"2026082308400580000_83.5.283.7","doi-asserted-by":"crossref","DOI":"10.3390\/ijms25158166","article-title":"Multisystemic Beryllium Disease: An Exceptional Case Revealed by a Urinary Tract Granulomatosis","volume":"25","author":"Jacobs","year":"2024","journal-title":"Int J Mol Sci"},{"key":"2026082308400580000_83.5.283.8","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/ajim.23676","article-title":"Sarcoidosis in Beryllium Exposed Workers: A Case-Case Study","volume":"68","author":"Mayer","year":"2025","journal-title":"Am J Ind Med"},{"key":"2026082308400580000_83.5.283.9","doi-asserted-by":"crossref","unstructured":"Rotenberg C , Tran Ba S , Marchand-Adam S , et al . BERYSARC: a multicentric control case study comparing chronic beryllium disease to pulmonary sarcoidosis. ERS Congress 2024 abstracts; September 14, 2024:A949. doi:10.1183\/13993003.congress-2024.OA949","DOI":"10.1183\/13993003.congress-2024.OA949"},{"key":"2026082308400580000_83.5.283.10","doi-asserted-by":"crossref","unstructured":"Beijer E , Meek B , Bossuyt X , et al . Immunoreactivity to metal and silica associates with sarcoidosis in Dutch patients. Respir Res 2020;21. doi:10.1186\/s12931-020-01409-w","DOI":"10.1186\/s12931-020-01409-w"},{"key":"2026082308400580000_83.5.283.11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.coi.2016.05.001","article-title":"Interplay of innate and adaptive immunity in metal-induced hypersensitivity","volume":"42","author":"McKee","year":"2016","journal-title":"Curr Opin Immunol"},{"key":"2026082308400580000_83.5.283.12","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1002\/ajim.23724","article-title":"Silicosarcoidosis: Histologic and Clinical Features of an Occupational Granulomatous Disease","volume":"68","author":"Hua","year":"2025","journal-title":"Am J Ind Med"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2025-110668","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:40:35Z","timestamp":1787499635000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2025-110668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,8,23]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/oemed-2025-110668"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2025-110668","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]}}}