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Failing to respond to targeted antimicrobials she was investigated by chest high-resolution CT and autoantibody screen to identify non-infective causes of her respiratory signs and symptoms. These demonstrated diffuse ground-glass change with peripheral honeycombing in keeping with fibrosis and alveolitis alongside high titres of anti-SS-A\/Ro antibodies. She was managed with reducing course of steroids and immunosuppression with cyclophosphamide. The rational of long-term immunosuppression was based on a presumed diagnosis of lung-dominant connective tissue disease, a disease concept proposed in contemporary medical literature.<\/jats:p>","DOI":"10.1136\/bcr-2017-223925","type":"journal-article","created":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T10:46:52Z","timestamp":1526986012000},"page":"bcr-2017-223925","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Ro-positive interstitial lung disease treated with cyclophosphamide"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-9355","authenticated-orcid":false,"given":"Nader","family":"Habib Bedwani","sequence":"first","affiliation":[{"name":"University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"},{"name":"Department of Respiratory Medicine, Warwick Hospital, Warwick, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Jefferson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Warwick Hospital, Warwick, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Marguerie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Warwick Hospital, Warwick, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayanta","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Warwick Hospital, Warwick, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,5,22]]},"reference":[{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201308-1483ST"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.2","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.3.3.190"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61079-4"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0194"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.09.003"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.6","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1007\/s00296-016-3463-x","article-title":"Dramatic improvement of anti-SS-A\/Ro-associated interstitial lung disease after immunosuppressive treatment","volume":"36","author":"Paola","year":"2016","journal-title":"Rheumatol Int"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.02.009"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.8","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e3181c1acec"},{"key":"2025082802062735000_2018.may21_1.bcr-2017-223925.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021933"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-223925","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:06:33Z","timestamp":1756371993000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-223925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,22]]},"references-count":9,"alternative-id":["10.1136\/bcr-2017-223925"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-223925","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,5,22]]}}}