Rheumatoid Pneumoconiosis (Caplan's Syndrome) in an Asbestos Worker

Dysregulation of the immune system caused by silica and asbestos

“…as actinolite, amosite, anthophyllite, chrysotile, crocidolite, or tremolite) is a mineral silicate containing iron, magnesium, and calcium, it is not reasonable to question whether exposure to asbestos also causes immunological alterations like (immunomodulatory) silica (Uber and McReynolds, 1982;Steenland and Goldsmith, 1995;Shanklin and Smalley, 1998). To date, only a handful of reports have been published detailing autoimmune disorders in asbestosexposed patients (Tellesson, 1961;Pfau et al, 2005;Noonan et al, 2006). The most typical health complications arising from asbestos exposure involve the development of malignant tumors associated with mesothelioma and lung cancers (Nicholson, 1984(Nicholson, , 2001Antman, 1986;Gruber, 1990;Niklinski et al, 2004).…”

Rheumatoid pneumoconiosis (Caplan's syndrome)

“…It consists in the association between silicosis and RA [2]. The radiological features consist in multiple well-defined round opacities, measured between 0.5 and 5 cm in diameter, distributed throughout both lung fields but predominantly at the periphery [8]. The association between long exposure to silica, pneumoconiosis and RA is proved [9].…”

Rheumatoid Pneumoconiosis in Association with Asbestosis

“…COMMENT So far as is known, this is only the third time that rheumatoid pneumoconiosis has been reported in association with asbestosis. Adequate descriptions of the microscopic findings in rheumatoid pneumoconiosis complicating asbestosis are available elsewhere (Rickards and Barrett, 1958;Tellesson, 1961), and in addition a complete and lucid account of the general pathology of Caplan's syndrome has been published (Gough, Rivers, and Seal, 1955). It seems unnecessary to describe in detail the microscopic findings in this case, as in this instance there seems little doubt of the diagnosis in view of the positive serological findings and the characteristic histological appearances.…”

“…The opacities that are found in Caplan's syndrome are usually more peripherally situated, tend to be multiple, and more commonly affect both lungs. The unusual radiological features that lead to the recognition of the syndrome were originally observed in a group of coal-miners with rheumatoid arthritis, though since then the syndrome has been described in other pneumoconioses, including asbestosis (Rickards and Barrett, 1958 ;Tellesson, 1961 ;Campbell, 1958). Furthermore, it is now realized that occasionally the parenchymal nodules may precede the development of arthritis by several years.…”