Chronic beryllium disease (CBD), or berylliosis, is an interstitial lung disease caused by the chronic inhalation of finely particulate beryllium, frequently mistaken for sarcoidosis. It is rarely associated with skin nodular lesions, asymptomatic granulomatous hepatitis or calcium nephrolithiasis. To date, it has never been reported as a diffused multi-organ granulomatous disease. A 60-year-old Pakistani man, a former excavation worker with ancient history of suspected sarcoidosis, underwent a left nephroureterectomy for suspected papillary kidney carcinoma. The histopathological analysis showed a benign non-necrotic granulomatous infiltration of the renal pelvis and ureter. Six months later, he suffered from two consecutive episodes of acute kidney failure. Bladder biopsies found similar noncaseous granulomatosis and kidney biopsies showed interstitial nephritis. Known for suspected asthma, sleep apnea, and usual interstitial pneumonia, the patient would regularly consult for episodes of pyrexia, chills, nocturnal coughing, and wheezing. As kidney function gradually worsened, he ultimately started hemodialysis and was transferred to our facility. A positive blood beryllium lymphocyte proliferation test confirmed the diagnosis of CBD. This original report is the first description of multi-organ berylliosis with diffused urothelial granulomatosis and pseudo-tumor. The patient’s pulmonary disease is minimal compared with renal and urinary tract involvement, eventually responsible for end-stage kidney disease. Berylliosis usually responds to glucocorticoids. This case report highlights the importance of evoking the diagnosis of CBD in the presence of any granulomatosis, even extra-thoracic, especially if associated with pulmonary symptoms, however atypical.

To assess the impact of metabolic stress on blood lactate, muscle damage, inflammatory and hormonal responses following a high-load (70% maximum) strength training session, we compared two methods with a similar number of repetitions but that differed by their metabolic demand: the 3/7 method consisting in two series of five sets of an increasing number of repetitions (3 to 7) with a short inter-set interval (15 s) and the 8 × 6 method that comprises eight sets of six repetitions with a longer inter-set interval (2.5 min). Blood concentrations in lactate, creatine kinase (CK), myoglobin (MB), interleukine-6 (IL-6), leukocytes, growth hormone (GH), insulin-like growth factor-1 (IGF-1) and cortisol were determined before and after each session. Lactate concentration increased more (11.9 vs. 3.1 mmol/L; p < 0.001) for the 3/7 method whereas CK and MB concentrations were augmented similarly (p > 0.05) for both methods. Inflammatory markers (leukocytes and IL-6) increased (p < 0.01) more after the 3/7 method. GH and cortisol concentrations also increased more (p < 0.001) after the 3/7 method with no difference in IGF-1 concentrations between methods. Positive associations were found between the change in lactate and changes in IL-6 (r² = 0.47; p < 0.01), GH (r² = 0.58; p < 0.001) and cortisol (r² = 0.61; p < 0.001) concentrations. In conclusion, the greater lactate accumulation induced by short inter-set intervals during a high-load training session is associated with enhanced inflammatory and hormonal responses, suggesting that metabolic stress might contribute to the greater adaptative response previously observed with this method.