Rheumatoid pneumoconiosis
RP; Caplan syndrome; Pneumoconiosis - rheumatoid; Silicosis - rheumatoid pneumoconiosis; Coal worker's pneumoconiosis - rheumatoid pneumoconiosisRheumatoid pneumoconiosis (RP, also known as Caplan syndrome) is swelling (inflammation) and scarring of the lungs. It occurs in people with rheumatoid arthritis who have breathed in dust, such as from coal (coal worker's pneumoconiosis) or silica.
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...
Read Article Now Book Mark ArticleCoal worker's pneumoconiosis
Coal worker's pneumoconiosis (CWP) is a lung disease that results from breathing in dust from coal, graphite, or man-made carbon over a long time. CW...
Read Article Now Book Mark ArticleSilica
Silicosis is a lung disease caused by breathing in (inhaling) silica dust.
Read Article Now Book Mark ArticleCauses
RP is caused by breathing in inorganic dust. This is dust that comes from grinding metals, minerals, or rock. After the dust enters the lungs, it causes inflammation. This can lead to the formation of many small lumps in the lungs and an airway disease similar to mild asthma.
It is not clear how RP develops. There are two theories:
- When people breathe in inorganic dust, it affects their immune system and leads to rheumatoid arthritis (RA). RA is an autoimmune disease in which the body's immune system attacks healthy body tissue by mistake.
Autoimmune disease
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
Read Article Now Book Mark Article - When people who already have RA or are at high risk for it are exposed to mineral dust, they develop RP.
Symptoms
Symptoms of RP are:
- Cough
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
Read Article Now Book Mark Article - Joint swelling and pain
Joint swelling
Joint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.
Read Article Now Book Mark Article - Lumps under the skin (rheumatoid nodules)
- Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Exams and Tests
Your health care provider will take a detailed medical history. It will include questions about your jobs (past and present) and other possible sources of exposure to inorganic dust. Your provider will also do a physical exam, paying special attention to any joint and skin disease.
Other tests can include:
- Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
Read Article Now Book Mark Article - CT scan of the chest
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Joint x-rays
This test is an x-ray of a knee, shoulder, hip, wrist, ankle, or other joint.
Read Article Now Book Mark Article - Lung function tests
Lung function tests
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
Read Article Now Book Mark Article - Rheumatoid factor test and other blood tests
Rheumatoid factor
Rheumatoid factor (RF) is a blood test that measures the amount of the RF antibody in the blood.
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Treatment
There is no specific treatment for RP, other than treating any lung and joint disease.
Stop exposure to coal dust.
Support Groups
Attending a support group with people who have the same disease or a similar disease can help you understand your condition better. It can also help you adjust to your treatment and lifestyle changes. Support groups take place online and in person. Ask your provider about a support group that might help you.
Outlook (Prognosis)
RP rarely causes serious breathing trouble or disability due to lung problems.
Possible Complications
These complications can occur from RP:
- Increased risk for tuberculosis
- Scarring in the lungs (progressive massive fibrosis)
- Side effects from medicines you take
When to Contact a Medical Professional
Contact your provider for an appointment if you have symptoms of RP and exposure to coal dust.
Talk to your provider about getting the flu and pneumonia vaccines.
If you've been diagnosed with RP, contact your provider right away if you develop a cough, shortness of breath, fever, or other signs of a lung infection, especially if you think you have the flu. Since your lungs are already damaged, it's very important to have the infection treated promptly. This will prevent breathing problems from becoming severe, as well as further damage to your lungs.
Prevention
People with RA should avoid exposure to inorganic dust.
References
Corte TJ, Wells AU. Connective tissue diseases. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 92.
Go LHT, Cohen RA. Pneumoconioses. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 101.
Raghu G, Martinez FJ. Interstitial lung disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 86.
Tarlo SM. Occupational lung disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 87.
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 5/3/2023
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.