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Reduced lung volumes and a positive fluoroscopic sniff test lead to a diagnosis of shrinking lung syndrome. Symptoms improved following treatment with glucocorticoids and non-invasive ventilation, but there was no change in lung function.<\/jats:p><jats:p>A year later, our patient presented again with worsening dyspnoea. This time echocardiography revealed severe mitral stenosis with pulmonary hypertension. Mitral valve replacement was performed and dyspnoea resolved. Histology showed Libman-Sachs endocarditis.<\/jats:p>","DOI":"10.1136\/bcr-2017-220162","type":"journal-article","created":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T06:45:41Z","timestamp":1510209941000},"page":"bcr-2017-220162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Dyspnoea in lupus"],"prefix":"10.1136","volume":"2017","author":[{"given":"Jeremy","family":"Fleri Soler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Borg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia","family":"Mercieca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00761.x"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2013.10.003"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.3","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e3181c1acec"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5152\/eurjrheum.2015.0085","article-title":"The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus","volume":"3","author":"\u00dcnl\u00fc","year":"2016","journal-title":"Eur J Rheumatol"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.5","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316630818"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.6","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000004626","article-title":"Shrinking lung syndrome in systemic lupus erythematosus: A case series and review of the literature","volume":"95","author":"Borrell","year":"2016","journal-title":"Medicine"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.04.003"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.8","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcw093"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.01.024"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.10","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1016\/j.athoracsur.2015.06.113","article-title":"Antiphospholipid syndrome and libman-sacks endocarditis in a bioprosthetic mitral valve","volume":"101","author":"Sladek","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2025042713015582000_2017.nov08_1.bcr-2017-220162.11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/216291","article-title":"Mitral valve surgery in patients with systemic lupus erythematosus","volume":"2014","author":"Foroughi","year":"2014","journal-title":"ScientificWorldJournal"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220162","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T20:02:02Z","timestamp":1745784122000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,8]]},"references-count":11,"alternative-id":["10.1136\/bcr-2017-220162"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220162","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,11,8]]}}}