Pulmonary Manifestations of Systemic Disease: Systemic Disease |

A Case Report of Rheumatoid Pneumoconiosis (Caplan Syndrome) FREE TO VIEW

Gu Weili, MMed; Nuofu Zhang, MMed
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Guangzhou Institute of Respiratory Disease, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A469. doi:10.1016/j.chest.2016.02.488
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SESSION TITLE: Systemic Disease

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Caplan’s syndrome, also referred to as rheumatoid pneumoconiosis (RP), is specific to rheumatoid arthritis (RA) and presents with multiple, well-defined necrotic nodules in workers exposed to dust.

CASE PRESENTATION: Here we report one case with a typical pulmonary presentation, confirmed through computed tomography (CT) and histopathological studies. A 58-year-old male patient with a diagnosis of RA, complained pain of multiple joints and mild dyspnea on exertion. He was an active smoker (40 pack- years) and worked as a shepherd for 35 years exposed to dust. High-resolution CT (HRCT) of the chest revealed bilateral, round, well-delimited nodules with peripheral distribution. After one month of treatment with corticosteroids and tripterygium wilfordii, the patient’s pain and dyspnea improved. In the meantime, the pulmonary nodules grew down gradually.

DISCUSSION: The case demonstrates the clinical presentation, radiological and pathological features of Caplan’s syndrome. It suggested the importance for differential diagnosis in the management of the patients suffered from pulmonary nodules with rheumatoid arthritis, especially from a pasturing area.

CONCLUSIONS: The effective treatment for Caplan’s syndrome is corticosteroids and tripterygium wilfordii.

Reference #1: Caplan A. Certain unusual radiological appearances in the chest of coal-miners suffering from rheumatoid arthritis. Thorax. 1953;8(1):29-37.

DISCLOSURE: The following authors have nothing to disclose: Gu Weili, Nuofu Zhang

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