Wang Ling, Liu Yanling, Zhang Yibin, Hu Yue
Department of Endocrinology and Rheumatology, the Third People's Hospital of YuHang District, China.
Department of Radiology, the Third People's Hospital of YuHang District, China.
J Int Med Res. 2025 Jun;53(6):3000605251353738. doi: 10.1177/03000605251353738. Epub 2025 Jun 30.
Caplan's syndrome, also known as rheumatoid pneumoconiosis, is characterized by pulmonary nodules and rheumatoid arthritis in patients with pneumoconiosis. Owing to its low incidence rate and the presence of multiple nodules on lung computed tomography, it is often mistaken for other pulmonary diseases. Herein, we report the case of a 60-year-old man who presented to the hospital with joint edema and recurrent polyarthralgia. Laboratory studies revealed higher levels of rheumatoid factor and anti-citrullinated peptide antibodies, together with an enhanced erythrocyte sedimentation rate. Chest high-resolution computed tomography revealed multiple bilateral nodules during the evaluation for treatment contraindications. Based on the patient's occupational background and findings from multidisciplinary consultations, a definitive diagnosis of Caplan syndrome was made. Maintenance therapy included low-dose methylprednisolone (gradually tapered and discontinued over 3 months), methotrexate, and hydroxychloroquine. The patient's arthralgia and pulmonary nodules demonstrated stability over a follow-up period of up to 4 years, thereby indicating the success of this treatment.
卡普兰综合征,又称类风湿性尘肺,其特征是尘肺患者出现肺结节和类风湿性关节炎。由于其发病率低且肺部计算机断层扫描显示有多个结节,它常被误诊为其他肺部疾病。在此,我们报告一例60岁男性病例,该患者因关节水肿和复发性多关节痛入院。实验室检查显示类风湿因子和抗瓜氨酸化肽抗体水平升高,同时红细胞沉降率加快。胸部高分辨率计算机断层扫描在评估治疗禁忌证时发现双侧多个结节。根据患者的职业背景和多学科会诊结果,确诊为卡普兰综合征。维持治疗包括低剂量甲泼尼龙(在3个月内逐渐减量并停用)、甲氨蝶呤和羟氯喹。在长达4年的随访期内,患者的关节痛和肺结节病情稳定,表明该治疗取得成功。