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Beryllium allergy has been found in patients with no known occupational exposure to beryllium. Beryllium is a very toxic substance but is nevertheless still used in certain dental materials. Beryllium is also found in cigarettes and may be ingested by drinking contaminated water or foodstuffs.
Below are three case reports of patients who showed extremely strong lymphocyte sensitization (allergy) to beryllium in vitro, as measured by the MELISA test. In one case the gold crown was analyzed for beryllium and found to contain the metal. Generally beryllium does not cause mitogenic (non-specific) lymphocyte stimulation in vitro.
Case report 1: 57-year old nurse with fibromyalgia
- Past occupational exposure to metals
- Clinical metal sensitivity (does not tolerate cheap earrings)
- Suffered from fibromyalgia and hypothyroid function
- Dental status: 3 big gold crowns, metal-bound ceramics, 3 amalgams
In 1996 she suffered whiplash damage in a car accident. She suspected that dental amalgam might contribute to her ill health and started replacing her amalgam fillings in 2001. Amalgam fillings were replaced with composite and ceramic restorations. Her symptoms became aggravated after dental treatment and the worsening lasted for 2 months. However, her health status did not improve considerably.
MELISA was performed in 2002 and showed a very strong reactivity to beryllium in the absence of any other reactivity detected (see diagram below). Since the patient was not aware of any recent beryllium exposure, she decided to remove her gold alloys as they might contain beryllium,. One gold crown was analyzed for the presence of beryllium by Analytica in Umeå, Sweden, according to modified EPA methods 200.7 (ICP-AES) and 200.8 (ICP-MS). Beryllium was detected in the concentration of 0.662 mg/kg (ICP-AES). In 2005, the patient still has metal-bound ceramic in her front teeth.
A Stimulation Index over 3 indicates a positive response or an allergic reaction. The reactivity of beryllium is SI: 68.9. A value over 10 is regarded as a strong reaction. Below is the response in MELISA to three different concentrations of beryllium salts in the same patient.
Case report 2: 43-year old female
- Suffered from Multiple Chemical Sensitivity, chronic fatigue, asthma, sinusitis
- Exposed to moulds in sick building for 10 years
- Clinical metal hypersensitivity
- Dental status: 3 root-fillings (one with brass pin), 7 amalgams, metal-bound ceramics in the front teeth
MELISA testing showed extremely high positive reaction to beryllium and a positive reaction to inorganic mercury and nickel. After amalgam removal the patient’s symptoms persisted. There was no occupational exposure to beryllium and the patient never smoked. A possible exposure could be the beryllium in the metal-bound ceramics. The patient decided to keep the front teeth.
Case report 3: 67-year old female
Chronic health problems aggravated in connection with dental treatment
Exposed to passive smoking for 10 years
Inflammation in the jaw bone
Patch test showed weak positive reaction to nickel and chromium (beryllium was not tested)
Dental status: 3 root-fillings (one with brass pin), 7 amalgams, gold crowns and bridges, pivot tooth
The patient did not remove any dental fillings and her ill-health continues.
More information about beryllium allergy:
- Agency for Toxic Substances and Disease Registry’s fact sheet on Beryllium: http://www.atsdr.cdc.gov/tfacts4.html