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Caplan syndrome

Rheumatoid pneumoconiosis

 

Caplan syndrome is swelling (inflammation) and scarring of the lungs. It occurs in people with rheumatoid arthritis who have breathed in mining dust that contains coal. This lung disease is also called coal worker's pneumoconiosis.

Causes

 

Caplan syndrome is caused by breathing in coal mining dust. This causes inflammation and can lead to the formation of many small lumps in the lungs and an airway disease similar to mild asthma.

Some people who have been exposed to coal dust have severe lung scarring that makes it difficult for their lungs to carry oxygen to their bloodstream (called progressive massive fibrosis). People with rheumatoid arthritis do not seem more likely to have this complication.

Caplan syndrome is very rare in the United States.

 

Symptoms

 

Symptoms of Caplan syndrome are:

  • Cough
  • Joint swelling and pain
  • Lumps under the skin (rheumatoid nodules)
  • Shortness of breath
  • Wheezing

 

Exams and Tests

 

Your health care provider will take a detailed medical history. It will include questions about your jobs (past and present) and other possible sources of exposure to mining dust. Your provider will also do a physical exam, paying special attention to any joint and skin disease.

Other tests can include:

  • Chest x-ray
  • CT scan of the chest
  • Joint x-rays
  • Pulmonary function tests
  • Rheumatoid factor test and other blood tests

 

Treatment

 

There is no specific treatment for Caplan syndrome, other than treating any lung and joint disease.

 

Support Groups

 

Attending a support group with people who have the same disease or a similar disease can help you understand your condition better. It can also help you adjust to your treatment and lifestyle changes. Support groups take place online and in person. Ask your provider about a support group that might help you.

 

Outlook (Prognosis)

 

Caplan syndrome rarely causes serious breathing trouble or disability due to lung problems.

 

Possible Complications

 

These complications can occur from Caplan syndrome:

  • Increased risk for tuberculosis
  • Scarring in the lungs (progressive massive fibrosis)
  • Side effects from medicines you take

 

When to Contact a Medical Professional

 

Call for an appointment with your provider if you have symptoms of Caplan syndrome.

 

Prevention

 

People with rheumatoid arthritis should avoid exposure to coal dust.

 

 

References

Corte TJ, Du Bois RM, Wells AU. Connective tissue diseases. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 65.

Cowie RL, Becklake MR. Pneumoconioses. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 73.

Raghu G. Interstitial lung disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 92.

Tarlo SM. Occupational lung disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 93.

 
  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Caplan syndrome

           

             

            Review Date: 6/22/2015

            Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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