Overview of Rheumatoid Pneumoconiosis
Rheumatoid pneumoconiosis, also known as Caplan’s syndrome, rheumatoid arthritis-pneumoconiosis syndrome, and silicosis arthritis, was discovered in 1953 by Caplan in the United Kingdom when he found that coal miners with pneumoconiosis had a combination of rheumatoid arthritis.Miall’s (1955) epidemiologic survey of men over 15 years of age found that genetic factors play an important role in the pathogenesis of rheumatoid arthritis and rheumatoid pneumoconiosis. Miall (1955) found that genetic factors play an important role in the pathogenesis of rheumatoid arthritis and rheumatoid pneumoconiosis.
Causes
1. Immunologic abnormalities
Pulmonary nodules are rare in rheumatoid arthritis without silicosis. Based on 28 patients reported by Walker (1966) over a 12-year period, it was suggested that pneumoconiosis may contribute to the formation of pulmonary nodules in rheumatoid joints.
2. Genetic factors
In an epidemiologic survey of men over 15 years of age, Miall (1955) found that genetic factors play an important role in the pathogenesis of rheumatoid arthritis and rheumatoid pneumoconiosis.
Symptoms
1. Respiratory system
There is cough, coughing black or brown sputum, hemoptysis, varying degrees of dyspnea, chest pain.
2. Bone and joint
Swelling and pain in wandering joints or other signs and symptoms of rheumatoid arthritis may occur before or after the pathological changes in the lungs. In some cases, the joint symptoms may not be obvious.
Tests
1. Immunologic examination
Rheumatoid factor is positive in 65% of cases. Serum albumin is lowered, α2 and γ-globulin are elevated, β-globulin is elevated with the development of the disease, and IgG and IgM are elevated.
2. Chest X-ray examination
Multiple nodular shadows are predominant, and the lesions may be single or multiple, with round or oval dense shadows with clear margins, varying in size from 0.5 to 1.5 centimeters in diameter, and occasionally 3 to 5 centimeters in diameter, often in the middle and outer bands of the middle and lower lung fields. Multiple foci are quite similar to metastatic tumors, but the central necrosis forms a thin-walled cavity, which is usually free of fluid flatness, and a few may be calcified.
Diagnosis.
The diagnosis can be made on the basis of the patient’s occupation, history of dust exposure, clinical manifestations such as dyspnea, arthritic symptoms, characteristic X-ray changes and positive rheumatoid factor.
Differential diagnosis
Rheumatoid pneumoconiosis is differentiated from the progressive massive fibrosis caused by silicosis, which has no active inflammatory layer and rheumatoid endarteritis. Differentiation from silicosis tuberculosis, which has an active inflammatory layer and a fibroblastic fenestrated layer, but tubercle bacilli are not detected in the active inflammatory layer.
Complications
It may be complicated by hemoptysis, dyspnea, chest pain, pulmonary hypertension, right ventricular hypertrophy and right heart failure.
Treatment
1. Treat silicosis and joint symptoms at the same time.
2. Hormone, immunosuppressant and chloroquine can be applied to rheumatoid lung damage.
3. Symptomatic treatment and control of secondary infection.
Questions you may be concerned about
How to take care of rheumatoid pneumoconiosis
Patients with rheumatoid pneumoconiosis should avoid contact with dusty environment, take medication on time, pay attention to daily diet, and do a good job in preventing cold and keeping joints warm and other related care.
1. Avoid contact with dusty environment. Dust irritation is one of the causes of rheumatoid pneumoconiosis, so it is important to stay away from the dust environment to minimize the further damage of dust to lung tissues.
2. Take medication on time. Patients with rheumatoid pneumoconiosis need to take anti-silicosis (aluminum citrate, piperaquine hydroxyphosphate), glucocorticoid (methylprednisolone, prednisone), non-steroidal anti-inflammatory drugs (aspirin), immunosuppressant (cyclophosphamide) and other medicines as prescribed by doctors. During the period of taking medicines, you should not stop taking medicines or increase or decrease the dosage of medicines, so as to avoid affecting the recovery of the disease.
3. Pay attention to daily diet. Patients should pay attention to balanced nutrition, eat more proteins, calcium, vitamins and other foods, and also eat some foods that are good for resolving phlegm and clearing heat; do not eat spicy and stimulating foods.
4. Do a good job of preventing cold and keeping warm in the joints. Because the disease also has the symptoms of rheumatoid arthritis, it is necessary to do a good job of preventing cold and keeping the joints warm in normal times; especially when going out in winter, one should wear scarves, gloves, masks, knee pads, etc. Usually, one should not wash hands in cool water, and one can often use warm water to apply hot compresses to the hands and feet.
It is recommended that patients with rheumatoid pneumoconiosis should go to the hospital in time and follow the doctor’s instructions to avoid delaying their condition.
Prognosis
Similar to rheumatoid arthritis and in some cases, the lung lesions can be relieved on their own, but some of them are accompanied by lifelong.