Title:Treatment with Rituximab in Rheumatoid Pneumoconiosis: A Case Report
Volume: 18
Issue: 3
Author(s): Makhlouf Yasmine*, Maatallah Kaouther, Kaffel Dhia, Ferjani Hanene, Triki Wafa, Ben Nessib Dorra and Hamdi Wafa
Affiliation:
- Department of Rheumatology, Mohammed Kassab National Institute of Orthopedics, Ksar Said, Mannouba 2010, Tunisia
Keywords:
Caplan syndrome, rheumatoid arthritis, rituximab, pneumoconiosis, AID, silicosis.
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.
Conclusion: 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.
