Caplan’s syndrome is also known as coal worker’s pneumoconiosis. It is common in coal miners, and can also be seen in individuals who have had long-term exposure to silica, coal dust, or asbestos. Caplan’s syndrome causes inflammation and scarring of the lungs in patients who already have rheumatoid arthritis. Rheumatiod arthritis is an autoimmune condition that causes joint swelling, pain, and joint deformity.
Over time, the number of Caplan’s syndrome diagnoses has decreased. This is because of improved mining regulations and techniques in the developed world. Risk is higher in countries where mining operations lack proper air filtration systems and other safety measures.
Patients with Caplan’s syndrome develop nodules in their lungs that can restrict breathing and cause symptoms similar to asthma. Scarring in the lungs may also occur, causing additional breathing problems. Smoking cigarettes may aggravate the condition.
Symptoms of this condition include:
- nodules on the skin (rheumatoid nodules)
- joint swelling and pain
- shortness of breath
Rheumatoid arthritis may cause your joints to become especially painful and swollen after periods of inactivity.
To diagnose Caplan’s syndrome, your doctor will need a detailed medical history. You will be asked about your previous and current employment. You should also discuss other possible exposures to coal dust, silica, or asbestos.
A thorough physical examination will be performed. Your doctor will use a stethoscope to listen to your lung sounds for evidence of breathing difficulties. The doctor will also pay careful attention to any signs of possible joint or skin disease.
Additional tests may include:
- a chest X-ray to look for lung nodules
- a computed tomography (CT) scan of the chest to look for lung nodules
- lung function tests
- joint X-rays to look for evidence of inflammation
- a rheumatoid factor blood test
There is no cure for Caplan’s syndrome. Treatment focuses on alleviating your lung and joint symptoms.
Over-the-counter anti-inflammatory medications, such as ibuprophen can reduce joint swelling and relieve arthritis symptoms. Corticosteroids, such as prednisone, can provide short-term relief of rheumatoid arthritis flare-ups. Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, may help stop (or at least slow) arthritis progression.
Bronchodilator medications, such as salmeterol, open the airways in your lungs. These can make breathing easier. Bronchodilators are usually given in the form of pills or inhalers.
Oxygen supplementation may also be necessary. Some people with Caplan’s syndrome don’t absorb enough oxygen when breathing. Getting oxygen via a tube in your nose can help make breathing easier and more efficient.
Other things you can do to improve your health include:
- getting routine flu vaccinations
- getting routine screenings for pneumonia, tuberculosis, and other lung conditions
- not smoking
Caplan’s syndrome is rarely fatal and serious breathing issues are uncommon. Chances are good that you won’t become disabled. Your doctor will continue to monitor the disease’s progression with periodic chest X-rays to make sure you are doing well.
Most cases of Caplan’s syndrome are discovered and treated before they become serious. However, Caplan’s syndrome can increase your risk of contracting tuberculosis (a bacterial infection of the lungs). It may also increase your risk of progressive massive fibrosis, which causes severe lung scarring.
Preventing Caplan’s syndrome isn’t difficult. If you have rheumatoid arthritis, you should avoid exposure to coal dust, silica, and asbestos.
If you work in a coal mine, you should take precautions. Your employer is responsible for providing you with protective equipment, such as a facemask to cover your nose and mouth. Safe mining practices can greatly reduce your risk of developing this disease.