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{{Infobox_Disease |
__NOTOC__
  Name          = {{PAGENAME}} |
{{Caplans syndrome}}
  Image          = |
  Caption        = |
  DiseasesDB    = 1961 |
  ICD10          = {{ICD10|J|99|0|j|95}} {{ICD10|M|05|1|m|05}} |
  ICD9          = {{ICD9|714.81}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 000137 |
  MeshID        = D002205 |
}}
{{SI}}


{{CMG}}
{{CMG}} {{AE}} {{SharmiB}}


{{SK}} Caplan's disease; Rheumatoid pneumoconiosis; rheumatoid arthritis-pneumoconiosis syndrome; rheumatoid lung
{{SK}} Caplan's disease; rheumatoid pneumoconiosis; rheumatoid arthritis-pneumoconiosis syndrome; rheumatoid lung
 
== Overview ==
Caplan syndrome is inflammation and scarring of the lungs in people with [[rheumatoid arthritis]] who have been exposed to coal dust.  This combination of [[rheumatoid arthritis]] and [[pneumoconiosis]] manifests itself as intrapulmonary nodules, which appear homogenous and well-defined on [[chest X-ray]].<ref>{{cite journal |author=Ondrasík M |title=Caplan's syndrome |journal=Baillieres Clin Rheumatol |volume=3 |issue=1 |pages=205-10 |year=1989 |pmid=2661027}}</ref>
 
==Historical Perspective==
Caplan's syndrome was originally described in coal miners with progressive massive [[fibrosis]].
 
==Pathophysiology==
Some people who have been exposed to the dust have severe lung scarring that makes it difficult for their lungs to carry oxygen to the bloodstream (called progressive massive [[fibrosis]]). People with [[rheumatoid arthritis]] do not seem more likely to have this complication of scarring.
 
==Causes==
Caplan syndrome is caused by breathing in coal mining dust. This causes inflammation and can lead to the development of many small lung lumps (nodules) and mild asthma-like airway disease.
 
The condition occurs in miners (especially those working in [[anthracite]] coal-mines), [[asbestosis]], [[silicosis]] and other pneumoconioses. There is probably also a genetic predisposition and [[smoking]] is thought to be an aggravating factor.
 
==Epidemiology and Demographics==
Persons with rheumatoid arthritis are more likely to develop larger areas of inflammation and scarring in response to coal dust. Caplan syndrome is very rare in the United States. [[Incidence]] is currently 1 in 100,000 people but is likely to fall as the coal mining industry declines.
 
==Signs and symptoms==
There is [[cough]] and [[shortness of breath]]. In addition there are the features of RA with [[joint pain]] and morning stiffness.
Examination should reveal tender, swollen [[MCP joints]] and [[rheumatoid nodules]]; [[auscultation]] of the chest may reveal diffuse [[râles]] that do not disappear on coughing or taking a deep breath.


==[[Caplans syndrome overview|Overview]]==
==[[Caplans syndrome historical perspective|Historical Perspective]]==
==[[Caplans syndrome classification|Classification]]==
==[[Caplans syndrome pathophysiology|Pathophysiology]]==
==[[Caplans syndrome causes|Causes]]==
==[[Caplans syndrome differential diagnosis|Differentiating Caplans syndrome from other Diseases]]==
==[[Caplans syndrome epidemiology and demographics|Epidemiology and Demographics]]==
==[[Caplans syndrome risk factors|Risk Factors]]==
==[[Caplans_syndrome_natural_history,_complications_and_prognosis|Natural History, Complications, and Prognosis]]==
==Diagnosis==
==Diagnosis==
*[[Chest X-ray|Chest radiology]] shows multiple, round, well defined [[nodules]], usually 0.5-2.0 cm in diameter, which may cavitate and resemble [[tuberculosis]].
[[Caplans syndrome history and symptoms|History and Symptoms]] | [[Caplans syndrome physical examination|Physical Examination]] | [[Caplans syndrome laboratory findings|Laboratory Findings]] | [[Caplans syndrome chest x ray|Chest X Ray]] | [[Caplans syndrome CT|CT]] | [[Caplans syndrome MRI|MRI]] | [[Caplans syndrome other imaging findings|Other Imaging Findings]] | [[Caplans syndrome other diagnostic studies|Other Diagnostic Studies]]
*[[Lung function tests]] may reveal a mixed restrictive and obstructive ventilatory defect with a loss of lung volume. There may also be irreversible airflow limitation and a reduced [[gas transfer factor]].
==Treatment==
*[[Rheumatoid factor]], [[antinuclear antibodies]], and non-organ specific antibodies may be present in the serum.
[[Caplans syndrome medical therapy|Medical Therapy]] | [[Caplans syndrome surgery|Surgery]] | [[Caplans syndrome primary prevention|Primary Prevention]] | [[Caplans syndrome secondary prevention|Secondary Prevention]]
*[[Silicosis]] and [[asbestosis]] must be considered in the differential with TB.
==Case Studies==
 
[[Caplans syndrome case study one|Case #1]]
Persons with Caplan syndrome may be at increased risk for [[tuberculosis]] ([[TB]]), and should be screened for exposure to TB.
 
==Management==
Once tuberculosis has been excluded, treatment is with [[steroids]]. All exposure to coal dust must be stopped, and [[smoking cessation]] should be attempted. Rheumatoid arthritis should be treated normally with early use of [[DMARDs]].
 
==Prognosis==
The nodules may pre-date the appearance of rheumatoid arthritis by several years. Otherwise prognosis is as for RA; lung disease may remit spontaneously, but pulmonary fibrosis may also progress. Coal worker's pneumoconiosis uncommonly causes significant breathing difficulty or disability.
 
==References==
<references/>


[[de:Caplan-Syndrom]]
[[de:Caplan-Syndrom]]

Latest revision as of 16:23, 15 July 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S

Synonyms and keywords: Caplan's disease; rheumatoid pneumoconiosis; rheumatoid arthritis-pneumoconiosis syndrome; rheumatoid lung

Overview

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