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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
Best fit. Severity of coal worker’s pneumoconiosis varies according to the composition of the coal. Simple coal worker’s pneumoconiosis is not associated with an increased risk of lung cancer. Caplan syndrome is associated with rheumatoid arthritis. There has been a recent resurgence of PMF in US coal miners.
Short answer questions (SAQs)
Published in Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon, Radiology for Undergraduate Finals and Foundation Years, 2018
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon
CXR findings that have a known association with rheumatoid arthritis include: Pleural effusion: unilateral in 92%. Exudative due to raised protein levels, may also contain rheumatoid factor, LDH.Pleural thickening: usually bilateral.Interstitial fibrosis: lower lobe predominance.Rheumatoid nodules: identical to the subcutaneous nodules found in advanced RhA.Caplan syndrome: hypersensitivity reaction to dust particles in coal workers who have rheumatoid arthritis (rare!).Bone abnormalities: do not forget the bones on a CXR! Although unlikely to be associated with dyspnoea, the question asks, more generally, for associations with RhA. A classical finding in RhA is resorption of the distal ends of the clavicles, other features include erosion of the acromioclavicular, shoulder, or sternoclavicular joints, and anklyosis of the vertebral bodies.Others: anti-rheumatoid drug side-effects: pericarditis / pericardial effusion.
Thorax
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
Pleural disease is the commonest manifestation (pleural effusion, pericarditis). Caplan’s syndrome occurs in patients with both rheumatoid lung and coal worker’s pneumoconiosis. Pulmonary arteritis has been described. Follicular bronchiolitis may occur (centrilobular nodules with ground-glass change).
Airborne pollutants as potential triggers of systemic autoimmune rheumatic diseases: a narrative review
Published in Acta Clinica Belgica, 2022
Hannelore Celen, Anne-Cathérine Dens, Steven Ronsmans, Stijn Michiels, Ellen De Langhe
There is also strong epidemiological evidence for a link between silica exposure and RA. Caplan described unusual radiological appearances in the chest of coal-miners in South Wales suffering from RA, known as ‘Caplan syndrome’ or ‘rheumatoid pneumoconiosis’ in 1953 [23]. Further observational studies have demonstrated a relationship between silica exposure and the development of RA, even in the absence of interstitial lung disease. A recent meta-analysis confirmed this relationship [24]. A large Swedish population-based case–control study could even observe a dose–response relationship between silica exposure and RA [25]. A recently published cohort study of the total Danish working population also showed an increased overall risk of SSc, RA, SLE and small vessel vasculitis with increasing cumulative exposure to respirable crystalline silica [26]. The results of these studies are summarized in Table 2.
Amyloid A amyloidosis in a patient with Caplan’s syndrome, with special reference to genetic predisposition
Published in Modern Rheumatology Case Reports, 2020
Tadashi Nakamura, Naoki Shiraishi, Yasuhiro Morikami, Hiromi Fujii, Takeshi Yoshinaga
Caplan’s syndrome has a characteristic nodular radiographic pattern in patients with RA and coal workers’ pneumoconiosis. This pattern consists of multiple well-defined rounded nodules on a chest radiograph, as originally defined by Caplan in 1953 [1]. Whereas, AA amyloidosis is an important complication of inflammatory diseases, and it is a significant, potentially life-threatening disorder that causes deposition in organs of AA fibrils, which are derived from the circulatory acute-phase reactant SAA [2,3]. During our preliminary investigation, we found no reports of AA amyloidosis in Caplan’s syndrome in the literature. Ondrasik reported that death often resulted from congestive heart failure, but secondary AA amyloidosis had not been reported in cases of Caplan’s syndrome [9]. Accordingly, AA amyloidosis has rarely been observed as a complication in Caplan’s syndrome, which we found in our case. The present case is, therefore, the first report of such a combination of AA amyloidosis and Caplan’s syndrome.
Crystalline silica activates the T-cell and the B-cell antigen receptor complexes and induces T-cell and B-cell proliferation
Published in Autoimmunity, 2019
Theodoros Eleftheriadis, Georgios Pissas, Sotirios Zarogiannis, Vassilios Liakopoulos, Ioannis Stefanidis
Besides lung fibrosis, an increased incidence of autoimmune diseases has also been linked to silicosis [2,3]. Caplan’s syndrome, the association between pneumoconiosis and rheumatoid arthritis, was described in coal miners in 1953 [4], and recent studies showed that silica exposure is accompanied by an almost three times increased risk of rheumatoid arthritis [5,6]. Erasmus syndrome, a combination of silicosis and progressive systemic sclerosis was described in gold miners in 1957 [7], with subsequent studies confirming the increased risk of progressive systemic sclerosis due to silica exposure [6,8]. Systemic lupus erythematosus has also been associated with silica exposure [6,9] and an increased incidence of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis has also been observed in patients with a history of silica exposure [6,10].