Caplans syndrome natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}} | {{CMG}}{{SharmiB}} | ||
{{Caplans syndrome}} | {{Caplans syndrome}} | ||
==Overview== | ==Overview== | ||
If left untreated, | If left untreated, some patients might develop irreversible pulmonary fibrosis. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
*The | *The patients with [[Caplan syndrome]] are mostly [[asymptomatic]] initially. <ref name="Benedek1973">{{cite journal|last1=Benedek|first1=Thomas G.|title=Rheumatoid pneumoconiosis|journal=The American Journal of Medicine|volume=55|issue=4|year=1973|pages=515–524|issn=00029343|doi=10.1016/0002-9343(73)90209-X}}</ref> <ref name="AlayaBraham2018">{{cite journal|last1=Alaya|first1=Zeineb|last2=Braham|first2=Mouna|last3=Aissa|first3=Sana|last4=Kalboussi|first4=Houda|last5=Bouajina|first5=Elyès|title=A case of Caplan syndrome in a recently diagnosed patient with silicosis: A case report|journal=Radiology Case Reports|volume=13|issue=3|year=2018|pages=663–666|issn=19300433|doi=10.1016/j.radcr.2018.03.004}}</ref> | ||
*The symptoms of | *Caplan [[nodules]] appear with or later than the onset of [[Rheumatoid arthritis|Rheumatoid arthritis.]]<ref name="LindarsDavies1967">{{cite journal|last1=Lindars|first1=D. C.|last2=Davies|first2=D.|title=Rheumatoid pneumoconiosis: A study in colliery populations in the East Midlands coalfield|journal=Thorax|volume=22|issue=6|year=1967|pages=525–532|issn=0040-6376|doi=10.1136/thx.22.6.525}}</ref> | ||
*If left untreated, | *Caplan [[nodules]] may lead to [[cavitation]] or [[calcification]] with [[pleural effusion]] or in rare cases [[Pneumothorax|pneumothorax]]. | ||
*[[Lung]] [[nodules]] in [[Caplan syndrome]] are rapidly growing; gain final size within weeks to month and then remain unchanged for years long. | |||
*Most of the [[lung]] [[nodules]] resolve spontaneously while some leave behind asteroid scarring. In 10% cases, [[cavitation]] and [[calcification]] happen. | |||
*There are cases of [[Caplan syndrome]] with radiologic findings of Caplan nodules but no [[rheumatoid factor]]. | |||
*The [[symptoms]] of [[dyspnea]] and [[cough]] typically develop with the progression of the [[disease]]. | |||
*If left untreated, patients with [[Caplan syndrome]] may progress to develop [[wheeze]] in the [[chest]] which doesn't change with [[cough]] suggestive of irreversible [[pulmonary fibrosis]]. | |||
===Complications=== | ===Complications=== | ||
Possible complications include: | Possible complications include<ref name="LindarsDavies1967">{{cite journal|last1=Lindars|first1=D. C.|last2=Davies|first2=D.|title=Rheumatoid pneumoconiosis: A study in colliery populations in the East Midlands coalfield|journal=Thorax|volume=22|issue=6|year=1967|pages=525–532|issn=0040-6376|doi=10.1136/thx.22.6.525}}</ref> <ref name="CaplanPayne1962">{{cite journal|last1=Caplan|first1=A.|last2=Payne|first2=R. B.|last3=Withey|first3=J. L.|title=A Broader Concept of Caplan's Syndrome Related to Rheumatoid Factors|journal=Thorax|volume=17|issue=3|year=1962|pages=205–212|issn=0040-6376|doi=10.1136/thx.17.3.205}}</ref>: | ||
* Increased risk for [[tuberculosis]] | * Increased risk for [[tuberculosis]] and [[aspergillosis]] | ||
* [[Hemoptysis]] | |||
* [[Pleural effusion]] | |||
* [[Pneumothorax]] | |||
* Progressive massive [[fibrosis]] (scarring) | * Progressive massive [[fibrosis]] (scarring) | ||
* Side effects of medications | * Side effects of medications | ||
===Prognosis=== | ===Prognosis=== | ||
Caplan syndrome rarely causes serious breathing trouble or disability due to lung problems. | Caplan syndrome rarely causes serious breathing trouble or disability due to lung problems.<ref name="CaplanPayne1962">{{cite journal|last1=Caplan|first1=A.|last2=Payne|first2=R. B.|last3=Withey|first3=J. L.|title=A Broader Concept of Caplan's Syndrome Related to Rheumatoid Factors|journal=Thorax|volume=17|issue=3|year=1962|pages=205–212|issn=0040-6376|doi=10.1136/thx.17.3.205}}</ref> | ||
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. | 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. | ||
Latest revision as of 02:33, 22 July 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Sharmi Biswas, M.B.B.S
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Overview
If left untreated, some patients might develop irreversible pulmonary fibrosis.
Natural History, Complications, and Prognosis
Natural History
- The patients with Caplan syndrome are mostly asymptomatic initially. [1] [2]
- Caplan nodules appear with or later than the onset of Rheumatoid arthritis.[3]
- Caplan nodules may lead to cavitation or calcification with pleural effusion or in rare cases pneumothorax.
- Lung nodules in Caplan syndrome are rapidly growing; gain final size within weeks to month and then remain unchanged for years long.
- Most of the lung nodules resolve spontaneously while some leave behind asteroid scarring. In 10% cases, cavitation and calcification happen.
- There are cases of Caplan syndrome with radiologic findings of Caplan nodules but no rheumatoid factor.
- The symptoms of dyspnea and cough typically develop with the progression of the disease.
- If left untreated, patients with Caplan syndrome may progress to develop wheeze in the chest which doesn't change with cough suggestive of irreversible pulmonary fibrosis.
Complications
Possible complications include[3] [4]:
- Increased risk for tuberculosis and aspergillosis
- Hemoptysis
- Pleural effusion
- Pneumothorax
- Progressive massive fibrosis (scarring)
- Side effects of medications
Prognosis
Caplan syndrome rarely causes serious breathing trouble or disability due to lung problems.[4]
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.
References
- ↑ Benedek, Thomas G. (1973). "Rheumatoid pneumoconiosis". The American Journal of Medicine. 55 (4): 515–524. doi:10.1016/0002-9343(73)90209-X. ISSN 0002-9343.
- ↑ Alaya, Zeineb; Braham, Mouna; Aissa, Sana; Kalboussi, Houda; Bouajina, Elyès (2018). "A case of Caplan syndrome in a recently diagnosed patient with silicosis: A case report". Radiology Case Reports. 13 (3): 663–666. doi:10.1016/j.radcr.2018.03.004. ISSN 1930-0433.
- ↑ 3.0 3.1 Lindars, D. C.; Davies, D. (1967). "Rheumatoid pneumoconiosis: A study in colliery populations in the East Midlands coalfield". Thorax. 22 (6): 525–532. doi:10.1136/thx.22.6.525. ISSN 0040-6376.
- ↑ 4.0 4.1 Caplan, A.; Payne, R. B.; Withey, J. L. (1962). "A Broader Concept of Caplan's Syndrome Related to Rheumatoid Factors". Thorax. 17 (3): 205–212. doi:10.1136/thx.17.3.205. ISSN 0040-6376.