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Tuberculosis & Respiratory Diseases

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Vol.70 No.2
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Caplan's Syndrome Presenting as Multiple Pulmonary Nodules

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2011, v.70 no.2, pp.150-154















& (2011). Caplan's Syndrome Presenting as Multiple Pulmonary Nodules. Tuberculosis & Respiratory Diseases, 70(2), 150-154.
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Abstract

We report a case of Caplan's Syndrome, which presented as multiple pulmonary nodules. A 58-year-old male was admitted to hospital due to multiple pulmonary nodules. In addition, the patient presented with multiple arthritis, and dyspnea on exertion. Rheumatoid arthritis had been diagnosed 35 years ago. The patient had worked as a stonemason for 20 years. Computed Tomography (CT) revealed numerous well-defined tiny nodules scattered in both lungs, which was suspicious of miliary tuberculosis or malignancy. The patient was started on antituberculous medications and referred to our hospital. First, a transbronchial lung biopsy was performed, which showed no evidence of granuloma. It was our opinion that the biopsy was insufficient, and a follow-up video-associated thoracoscopy was performed. The pathological report determined necrotizing granulomatous inflammation and silicosis on background. According to imaging studies, pathologic reports, and clinical symptoms, we concluded that the patient had Caplan's syndrome. We controlled his rheumatic medications, and instructed him to avoid exposure to hazardous dust.

keywords
Caplan Syndrome, Multiple Pulmonary Nodules, Arthritis, Rheumatoid, Caplan Syndrome, Multiple Pulmonary Nodules, Arthritis, Rheumatoid

Reference

1.

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

2.

2. Caplan A. Rheumatoid disease and pneumoconiosis (Caplan's syndrome). Proc R Soc Med 1959;52:1111-3.

3.

3. Verhaeghe A, Voisin C, Grailles M, Delcambre B, Bouscatie F. Developmental aspects of Caplan's syndrome. Rev Rhum Mal Osteoartic 1969;36:109-23.

4.

4. Caplan A. Rheumatoid pneumoconiosis syndrome. Med Lav 1965;56:494-9.

5.

5. Gough J, Rivers D, Seal RM. Pathological studies of modified pneumoconiosis in coal-miners with rheumatoid arthritis; Caplan's syndrome. Thorax 1955;10:9-18.

6.

6. Zielonka TM, Bareła D, Zukowska M, Langfort R, Rudziński P, Chazan R. Caplan's syndrome: case report. Pol Arch Med Wewn 2005;114:779-84.

7.

7. Benedek TG. Rheumatoid pneumoconiosis. Documentation of onset and pathogenic considerations. Am J Med 1973;55:515-24.

8.

8. Darke C, Wagner MM, Nuki G, Dyer PA. HLA-A, B and DR antigens and properdin factor B allotypes in Caplan's syndrome. Br J Dis Chest 1983;77:235-42.

9.

9. Hahon N, Morgan WK, Petersen M. Serum immunoglobulin levels in coal workers' pneumoconiosis. Ann Occup Hyg 1980;23:165-74.

10.

10. Payne RB. Serum protein fractions in rheumatoid pneumoconiosis without arthritis. J Clin Pathol 1962;15: 475-7.

11.

11. Ondrasík M. Caplan's syndrome. Baillieres Clin Rheumatol 1989;3:205-10.

12.

12. Allison AC, Harington JS, Birbeck M. An examination of the cytotoxic effects of silica on macrophages. J Exp Med 1966;124:141-54.

13.

13. Pernis B. Silica and the immune system. Acta Biomed 2005;76 Suppl 2:38-44.

14.

14. Schreiber J, Koschel D, Kekow J, Waldburg N, Goette A, Merget R. Rheumatoid pneumoconiosis (Caplan's syndrome). Eur J Intern Med 2010;21:168-72.

15.

15. Honma K, Vallyathan V. Rheumatoid pneumoconiosis: a comparative study of autopsy cases between Japan and North America. Ann occup Hyg 2002;46 Suppl 1:265-7.

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