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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Caplans syndrome differential diagnosis

Introduction

Overview

Overview

Caplan syndrome must be differentiated from asbestosis, silicosis, and tuberculosis.

Differentiating Caplan syndrome from other Diseases

Differentiating Caplan syndrome from other Diseases

Caplan syndrome must be differentiated from asbestosis, silicosis and other respiratory diseases with lung lesions.

Disease Findings
Bacterial pneumonia Sudden onset of symptoms, such as high fever, cough, purulent sputum, chest pain, leukocytosis, chest X-ray shows consolidation.
Bronchogenic carcinoma may be asymptomatic, usually at older ages (> 50 years old), cough, hemoptysis, weight loss
Brucellosis Fever, anorexia, night sweats, malaise,back pain , headache, and depression. History of exposure to infected animal
Hodgkin lymphoma Fever, night sweats, pruritus, painless adenopathy, mediastinal mass
Mycoplasmal pneumonia Gradual onset of dry cough, headache, malaise, sore throat. Diffuse bilateral infiltrates on chest X-ray.
Sarcoidosis Non-caseating granulomas in lungs and other organs, bilateral hilar lymphadenopathy, mostly in African American females.
Caplan syndrome Initially asymptomatic but advanced stages are associated with shortness of breath, cough and wheeze in the chest. Mostly in miners with preexisting rheumatoid arthritis.
Adapted from Mandell, Douglas, and Bennett’s principles and practice of infectious diseases 2010 [1]
Causes of

lung cavities

Differentiating Features Differentiating radiological findings Diagnosis

confirmation

  • CXR and CT demonstrates cavities in the upper lobe of the lung
  • Sputum smear-positive for acid-fast bacilli and nucleic acid amplification tests (NAAT) is used on sputum or any sterile fluid for rapid diagnosis and is positive for mycobacteria.
  • Any age group
  • Acute, fulminant life threating complication of prior infection
  • >100.4F fever, with hemodynamic instability
  • Worsening pneumonia-like symptoms
  • CBC is positive for the causative organism
  • Children and elderly are at risk
  • Empyema appears lenticular in shape and has a thin wall with smooth luminal margins
  • Pulmonary nodules with cavities and infiltrates are a frequent manifestation of CXR
  • Elderly females of 40-50 age group
  • Manifestation of rheumatoid arthritis
  • Presents with other systemic symptoms including symmetric arthritis of the small joints of the hands and feet and morning stiffness are common manifestations.
  • Pulmonary nodules with cavitation are present in the upper lobe (Caplan syndrome) on Xray.
  • On CXR bilateral adenopathy and coarse reticular opacities are seen.
  • CT of the chest demonstrates extensive hilar and mediastinal adenopathy
  • Additional findings on CT include fibrosis (honeycomb, linear, or associated with bronchial distortion), pleural thickening, and ground-glass opacities.
  • Common appearance on CT is patchy consolidation,often accompanied by ground-glass opacities and nodules.
  • Exclusively occurs in smokers, with a peak age of onset 20-40 years.
  • Clinical presentation is variable, but symptoms generally include months of dry cough, fever, night sweats and weight loss.
  • Skin is involved in 80% of the cases, scaly erythematous rash is typical.
  • Thin-walled cystic cavities are the usual radiographic manifestation, observed in over 50% of patients by either CXR or CT scans.
  • Biopsy of the lung
Caplan syndrome

Synonyms and keywords: Caplan’s disease; rheumatoid pneumoconiosis; rheumatoid arthritis-pneumoconiosis syndrome; rheumatoid lung

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Caplans syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S

References

References

  1. ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Chaudhuri MR (1973). “Primary pulmonary cavitating carcinomas”. Thorax. 28 (3): 354–66. PMC 470041. PMID 4353362.
  3. ↑ 3.0 3.1 Langford CA, Hoffman GS (1999). “Rare diseases.3: Wegener’s granulomatosis”. Thorax. 54 (7): 629–37. PMC 1745525. PMID 10377211.
  4. ↑ 4.0 4.1 Schreiber, J.; Koschel, D.; Kekow, J.; Waldburg, N.; Goette, A.; Merget, R. (2010). “Rheumatoid pneumoconiosis (Caplan’s syndrome)”. European Journal of Internal Medicine. 21 (3): 168–172. doi:10.1016/j.ejim.2010.02.004. ISSN 0953-6205.
  5. ↑ 5.0 5.1 Al-Ghanem S, Al-Jahdali H, Bamefleh H, Khan AN (2008). “Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review”. Ann Thorac Med. 3 (2): 67–75. doi:10.4103/1817-1737.39641. PMC 2700454. PMID 19561910.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sharmi Biswas, M.B.B.S