Monday, April 19, 2010

- Caplan's syndrome.

Caplan's syndrome

*Def:-It is is a combination of rheumatoid arthritis and pneumoconiosis that manifests as intrapulmonary nodules.
*Synonyms:- rheumatoid pneumoconiosis.
It occurs only in patient with both rheumatoid arthritis and pneumoconiosis related to mining dust (coal, asbestos, silica)so occurs in miners (especially those working in anthracite coal-mines), asbestosis, silicosis and other pneumoconioses.

*Clinical picture:-
  • Cough.
  • Joint swelling and pain.
  • Nodules of the skin (rheumatoid nodules).
  • Shortness of breath.
  • Wheezing.
  • Chest x-ray:- shows multiple, round, well defined nodules, usually 0.5 - 2.0 cm in diameter, which may cavitate and resemble tuberculosis.
  • Joint x-rays show features of rheumatoid arthritis.
  • Pulmonary function tests:-may reveal a mixed restrictive and obstructive ventilatory defect with a loss of lung volume and there may also be irreversible airflow limitation and a reduced DLCO.
  • Rheumatoid factor titer tests (+ve).
  • Once tuberculosis has been excluded, treatment is with steroids.
  • All exposure to coal dust must be stopped
  • Smoking cessation should be attempted.
  • Rheumatoid arthritis should be treated as usual.
    Dr Ibrahim
    Return to list of medical syndromes here

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