Caplans syndrome differential diagnosis: Difference between revisions

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*Biopsy of the lung
*Biopsy of the lung
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|Caplan syndrome
|[[Caplan syndrome]]
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*Mostly occurs in miners with rheumatoid arthritis.
*Mostly occurs in miners with [[rheumatoid arthritis]].<ref name="SchreiberKoschel2010">{{cite journal|last1=Schreiber|first1=J.|last2=Koschel|first2=D.|last3=Kekow|first3=J.|last4=Waldburg|first4=N.|last5=Goette|first5=A.|last6=Merget|first6=R.|title=Rheumatoid pneumoconiosis (Caplan's syndrome)|journal=European Journal of Internal Medicine|volume=21|issue=3|year=2010|pages=168–172|issn=09536205|doi=10.1016/j.ejim.2010.02.004}}</ref>
*Usually asymptomatic in the initial stages. Dyspnea and cough can occur in advanced stages.
*Usually [[asymptomatic]] in the initial stages. [[Dyspnea]] and [[cough]] can occur in advanced stages.
*Miners with Caplan nodule without rheumatoid arthritis can develop arthritis after 5-10 years later.
*Miners with Caplan [[nodule]] without [[rheumatoid arthritis]] can develop [[arthritis]] after 5-10 years later.
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* Well-defined, cavitating lung nodules of 0.5-5 cm are the usual finding in a chest x-ray and CT scan.  
* Well-defined, cavitating [[lung]] [[nodules]] of 0.5-5 cm is the usual finding in a [[chest x-ray]] and [[CT scan]].  
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* Biopsy of the lung nodules.
* [[Biopsy]] of the [[lung]] [[nodules]].
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Revision as of 03:48, 17 June 2021

link=https://www.wikidoc.org/index.php/Caplans syndrome
link=https://www.wikidoc.org/index.php/Caplans syndrome


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

Overview

Caplan syndrome must be differentiated from Asbestosis, Silicosis, and Tuberculsosis.

Differentiating Caplan syndrome from other Diseases

Caplan syndrome must be differentiated from asbestosis, silicosis.


Disease Findings
Bacterial pneumonia Sudden onset of symptoms, such as high fever, cough, purulent sputum, chest pain, leukocytosis, chest X-ray shows consolidation.
Bronchogenic carcinoma may be asymptomatic, usually at older ages (> 50 years old), cough, hemoptysis, weight loss
Brucellosis Fever, anorexia, night sweats, malaise,back pain , headache, and depression. History of exposure to infected animal
Hodgkin lymphoma Fever, night sweats, pruritus, painless adenopathy, mediastinal mass
Mycoplasmal pneumonia Gradual onset of dry cough, headache, malaise, sore throat. Diffuse bilateral infiltrates on chest X-ray.
Sarcoidosis Non-caseating granulomas in lungs and other organs, bilateral hilar lymphadenopathy, mostly in African American females.
Caplan syndrome
Adapted from Mandell, Douglas, and Bennett's principles and practice of infectious diseases 2010


Causes of

lung cavities

Differentiating Features Differentiating radiological findings Diagnosis

confirmation

  • CXR and CT demonstrates cavities in the upper lobe of the lung
  • Sputum smear-positive for acid-fast bacilli and nucleic acid amplification tests (NAAT) is used on sputum or any sterile fluid for rapid diagnosis and is positive for mycobacteria.
  • Any age group
  • Acute, fulminant life threating complication of prior infection
  • >100.4F fever, with hemodynamic instability
  • Worsening pneumonia-like symptoms
  • CBC is positive for the causative organism
  • Children and elderly are at risk
  • Empyema appears lenticular in shape and has a thin wall with smooth luminal margins
  • Pulmonary nodules with cavities and infiltrates are a frequent manifestation of CXR
  • Elderly females of 40-50 age group
  • Manifestation of rheumatoid arthritis
  • Presents with other systemic symptoms including symmetric arthritis of the small joints of the hands and feet and morning stiffness are common manifestations.
  • Pulmonary nodules with cavitation are present in the upper lobe (Caplan syndrome) on Xray.
  • On CXR bilateral adenopathy and coarse reticular opacities are seen.
  • CT of the chest demonstrates extensive hilar and mediastinal adenopathy
  • Additional findings on CT include fibrosis (honeycomb, linear, or associated with bronchial distortion), pleural thickening, and ground-glass opacities.
  • Common appearance on CT is patchy consolidation,often accompanied by ground-glass opacities and nodules.
  • Exclusively occurs in smokers, with a peak age of onset 20-40 years.
  • Clinical presentation is variable, but symptoms generally include months of dry cough, fever, night sweats and weight loss.
  • Skin is involved in 80% of the cases, scaly erythematous rash is typical.
  • Thin-walled cystic cavities are the usual radiographic manifestation, observed in over 50% of patients by either CXR or CT scans.
  • Biopsy of the lung
Caplan syndrome
  1. Chaudhuri MR (1973). "Primary pulmonary cavitating carcinomas". Thorax. 28 (3): 354–66. PMC 470041. PMID 4353362.
  2. Langford CA, Hoffman GS (1999). "Rare diseases.3: Wegener's granulomatosis". Thorax. 54 (7): 629–37. PMC 1745525. PMID 10377211.
  3. Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN (2008). "Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review". Ann Thorac Med. 3 (2): 67–75. doi:10.4103/1817-1737.39641. PMC 2700454. PMID 19561910.
  4. Schreiber, J.; Koschel, D.; Kekow, J.; Waldburg, N.; Goette, A.; Merget, R. (2010). "Rheumatoid pneumoconiosis (Caplan's syndrome)". European Journal of Internal Medicine. 21 (3): 168–172. doi:10.1016/j.ejim.2010.02.004. ISSN 0953-6205.

References