Caplans syndrome natural history, complications and prognosis
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.