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On retrospective review of patient records, from 8 years prior to presentation, lung biopsy histology consistent with bronchiolitis obliterans organising pneumonia with positive ANA serology was found, without any further autoimmune work-up. In our opinion, bronchiolitis obliterans organising pneumonia was the index presentation of SLE. Treatment with steroids and subsequent management with immunosuppressive therapy could have prevented subsequent hospitalisations. Prompt work-up for autoimmune diseases should be considered in patients with positive ANA and histological evidence of bronchiolitis obliterans organising pneumonia.<\/jats:p>","DOI":"10.1136\/bcr-2017-224094","type":"journal-article","created":{"date-parts":[[2018,5,26]],"date-time":"2018-05-26T08:29:30Z","timestamp":1527323370000},"page":"bcr-2017-224094","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Bronchiolitis obliterans organising pneumonia as an initial manifestation in a patient with systemic lupus erythematosus: a rare presentation"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9743-6710","authenticated-orcid":false,"given":"Shraddha","family":"Jatwani","sequence":"first","affiliation":[{"name":"Henry Ford Allegiance Health, Jackson, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richa","family":"Handa","sequence":"additional","affiliation":[{"name":"Henry Ford Allegiance Health, Jackson, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Jatwani","sequence":"additional","affiliation":[{"name":"Mount Sinai Health System, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Chugh","sequence":"additional","affiliation":[{"name":"Wayne State University, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,5,26]]},"reference":[{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198501173120304"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199507000-00004"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/8431741","article-title":"Bronchiolitis obliterans organizing pneumonia as an initial presentation of systemic lupus erythematosus: a rare case report and literature review","volume":"2016","author":"Wang","year":"2016","journal-title":"Case Rep Med"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.4","first-page":"2254","article-title":"Bronchiolitis obliterans organizing pneumonia as an initial manifestation in patients with systemic lupus erythematosus","volume":"24","author":"Min","year":"1997","journal-title":"J Rheumatol"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.102.4.1171"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.6","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20224"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.7","first-page":"9","article-title":"[Three cases with systemic rheumatic diseases who developed pulmonary lesions suggestive of bronchiolitis obliterans organizing pneumonia]","volume":"35","author":"Nakamura","year":"1995","journal-title":"Ryumachi"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.8","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.2.159"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.9","doi-asserted-by":"publisher","DOI":"10.4103\/1817-1737.39641"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.10","doi-asserted-by":"crossref","first-page":"231","DOI":"10.2169\/internalmedicine.35.231","article-title":"Polymyositis and Sj\u00f6gren\u2019s syndrome associated with bronchiolitis obliterans organizing pneumonia","volume":"35","author":"Imasaki","year":"1996","journal-title":"Intern Med"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.11","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199303000-00005."},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.12","doi-asserted-by":"publisher","DOI":"10.1186\/ar3097"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.102.3.715"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.14","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/00063198-199803000-00006","article-title":"Heterogeneity of bronchiolitis obliterans organizing pneumonia","volume":"4","author":"Epler","year":"1998","journal-title":"Curr Opin Pulm Med"},{"key":"2025082800350634000_2018.may25_1.bcr-2017-224094.15","unstructured":"In: King TE , MI BS , King TE , eds. 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