Abstract:
BACKGROUND: Caplan\'s syndrome, also known as rheumatoid pneumoconiosis (RP), is a rare disease associating pneumoconiosis with rheumatoid arthritis (RA). This is one of the rare cases evaluating the effect of Rituximab, which was used initially for the treatment of RA, on pneumoconiosis Case Presentation: In this case report, we described a 21-year long-standing history of pneumoconiosis and its association with RA. A 67-year-old man diagnosed with pneumoconiosis presented with morning stiffness and symmetrical polyarthritis. Laboratory investigations showed high titers of rheumatoid factor (RF) and anti-citrullinated protein antibodies. The diagnosis of RA was established and the patient was put on leflunomide. Then, he was treated with Rituximab, as he did not respond to leflunomide. The patient showed marked improvement as pain and swelling decreased. More importantly, Caplan\'s nodules stabilized on chest-computed tomography.
CONCLUSIONS: The use of rituximab in pneumoconiosis does not alter the evolution of the pulmonary nodules. More trials are needed to establish a treatment consensus for RP.
摘要:
背景:卡普兰综合征,也被称为类风湿尘肺(RP),是尘肺与类风湿关节炎(RA)相关的罕见疾病。这是评估利妥昔单抗效果的罕见病例之一,最初用于治疗RA,关于尘肺病例介绍:在本病例报告中,我们描述了21年的尘肺病史及其与RA的相关性.一名67岁的男子被诊断为尘肺,表现为晨僵和对称性多关节炎。实验室研究显示高滴度的类风湿因子(RF)和抗瓜氨酸化蛋白抗体。确定了RA的诊断,并对患者进行了来氟米特治疗。然后,他接受了利妥昔单抗治疗,因为他对来氟米特没有反应。随着疼痛和肿胀的减轻,患者表现出明显的改善。更重要的是,Caplan的结节在胸部计算机断层扫描上稳定。
结论:在尘肺中使用利妥昔单抗不会改变肺结节的演变。需要更多的试验来建立RP的治疗共识。