Korean J Med.  2013 Mar;84(3):428-432. 10.3904/kjm.2013.84.3.428.

A Case of Rheumatoid Pneumoconiosis Presenting with Pleuritis and Pericarditis

• Park MS
• Kang DG
• Jung EJ
• Oh KJ
• Sim JS
• Kim EJ
• Kim C

• KMID: 1833856
• DOI: http://doi.org/10.3904/kjm.2013.84.3.428

Abstract

Caplan's syndrome is characterized by multiple small distinct nodules with progressive massive fibrosis and rheumatic arthritis in pneumoconiosis. Although pleural effusions occur infrequently as an extra-articular manifestation, pleuritis can develop without joint involvement in patients with rheumatoid arthritis. We treated an 81-year-old man who had been diagnosed with silicosis with progressive massive fibrosis. He suffered from progressive dyspnea, and chest computed tomography (CT) and echocardiography revealed pleural and pericardial effusions. We speculated that the multiple serositis was related to a rheumatic disorder because the rheumatic factor was elevated in both the pleural and pericardial effusions. After corticosteroid treatment, the serositis improved. We suggest that this case is an atypical pattern of Caplan's syndrome presenting as serositis without arthritis. Rheumatoid serositis should be considered as the cause of pleural or pericardial effusions in patients with pneumoconiosis.

Keyword

Caplan's syndrome; Silicosis; Serositis

MeSH Terms

Arthritis
Arthritis, Rheumatoid
Caplan Syndrome
Dyspnea
Echocardiography
Fibrosis
Humans
Joints
Pericardial Effusion
Pericarditis
Pleural Effusion
Pleurisy
Pneumoconiosis
Rheumatic Fever
Serositis
Silicosis
Thorax