Caplan’s syndrome

Alternative names
Rheumatoid pneumoconiosis

Caplan’s syndrome is inflammation and scarring of the lungs in people with rheumatoid arthritis who have exposure to coal dust.

Causes, incidence, and risk factors

Inhalation of coal dust causes inflammation and scarring of the lung. Persons with rheumatoid arthritis are more prone to develop larger areas of inflammation and scarring in response to coal dust. Caplan’s syndrome is very rare in the USA.


  • cough  
  • shortness of breath  
  • nodules of the skin (rheumatoid nodules)  
  • joint swelling and pain

Signs and tests

Your health care provider will take a detailed medical history that will include questions about your occupations (past and present) and other possible sources of exposure to coal dust. A physical exam, with special attention paid to the presence of joint and skin disease, will be performed. Other tests that may aid in the diagnosis include:

  • chest X-ray  
  • joint X-rays  
  • pulmonary function tests  
  • rheumatoid factortiter test

There is no specific treatment for Caplan’s syndrome. It is important to treat the rheumatoid arthritis.

Support Groups
Attending support groups with other persons who have similar diseases may help you understand your disease and adjust to its treatment and other changes in your lifestyle.

Expectations (prognosis)
Coal worker’s pneumoconiosis uncommonly causes significant breathing difficulty or disability. Persons with Caplan’s syndrome may be at increased risk for tuberculosis (TB), and should be screened for exposure to TB.


  • side effects of medications  
  • increased risk for tuberculosis  
  • progressive massive fibrosis

Calling your health care provider
Call for an appointment with your health care provider if symptoms occur that are suggestive of Caplan’s syndrome.

People with rheumatoid arthritis should avoid exposure to hazardous dust.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.