Caplan syndrome

Definition

Caplan syndrome is inflammation and scarring of the lungs in people with rheumatoid arthritis who have been exposed to coal dust.

Alternative Names

Causes

Breathing in coal dust causes inflammation and scarring of the lung. 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.

Symptoms

• Cough
• Shortness of breath
• Nodules of the skin (rheumatoid nodules)
• Joint swelling and pain

Exams and Tests

Your health care provider will take a detailed medical history that will include questions about your occupations (past and present) and other possible sources of exposure to coal dust. A physical exam, with special attention paid to the presence of joint and skin disease, will be performed. Other tests that may aid in the diagnosis include:

• Chest x-ray
• Joint x-rays
• Pulmonary function tests
• Rheumatoid factor titer test

Treatment

There is no specific treatment for Caplan syndrome.

Support Groups

Attending support groups with other persons who have similar diseases may help you understand your disease and adjust to its treatment and other changes in your lifestyle.

Outlook (Prognosis)

Coal worker's pneumoconiosis uncommonly causes significant breathing difficulty or disability. Persons with Caplan syndrome may be at increased risk for tuberculosis (TB), and should be screened for exposure to TB.

Possible Complications

• Side effects of medications
• Increased risk for tuberculosis
• Progressive massive fibrosis (scarring)

When to Contact a Medical Professional

Call for an appointment with your health care provider if symptoms occur that are suggestive of Caplan syndrome.

Prevention

People with rheumatoid arthritis should avoid exposure to hazardous dust.

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000:1619-1721.

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