{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:54:21Z","timestamp":1773028461144,"version":"3.50.1"},"reference-count":5,"publisher":"BMJ","issue":"6362","license":[{"start":{"date-parts":[[1983,1,29]],"date-time":"1983-01-29T00:00:00Z","timestamp":412646400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,1,29]]},"abstract":"<jats:p>A patient with generalised cutaneous and gastrointestinal scleroderma subsequently died from respiratory failure secondary to hyperventilation. At necropsy changes consistent with scleroderma of the diaphragm were found; these were thought to have contributed appreciably to the terminal respiratory failure.<\/jats:p>\n                  <jats:p>This case indicates that diaphragmatic changes should be added to the list of respiratory complications of scleroderma.<\/jats:p>","DOI":"10.1136\/bmj.286.6362.337","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"337-338","source":"Crossref","is-referenced-by-count":11,"title":["Hypoventilatory respiratory failure in generalised scleroderma"],"prefix":"10.1136","volume":"286","author":[{"given":"Gerald D","family":"Iliffe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman M","family":"Pettigrew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,1,29]]},"reference":[{"key":"ref_1","first-page":"463","article-title":"Thoracic manifestations of collagen diseases","volume-title":"Textbook of pulmonary disease","author":"Bader, R.A.; Bader, M.E.","year":"1974","unstructured":"Bader RA, Bader ME. Thoracic manifestations of collagen diseases. In: Baum GL, ed. Textbook of pulmonary disease. 2nd ed. Boston: Little, Brown and Co, 1974:463-7.","edition":"2nd ed"},{"key":"ref_2","first-page":"962","article-title":"Progressive systemic sclerosis (scleroderma)","volume-title":"allied conditions","author":"Rodnan, G.P.","year":"1972","unstructured":"Rodnan GP. Progressive systemic sclerosis (scleroderma). In: Hollander JL, McCarty DJ Jr, eds. Arthritis and allied conditions. Philadelphia: Lea and Febiger, 1972:962-1005."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1002\/art.1780210111","article-title":"Muscle disease in progressive systemic sclerosis","volume":"21","author":"Clements, P.J.; Furst, D.E.; Campion, D.S.","year":"1978","unstructured":"Clements PJ, Furst DE, Campion DS, et al. Muscle disease in progressive systemic sclerosis. Arthritis Rheum 1978;21:62-71.","journal-title":"Arthritis Rheum"},{"key":"ref_4","article-title":"Accepted","year":"1982","unstructured":"(Accepted 23 November 1982)"},{"key":"ref_5","article-title":"Antibodies to the acetylcholine receptor and HLA antigens have been studied in patients with myasthenia gravis occurring in association with penicillamine treatment. The properties of the antiacetylcholine receptor in these patients differed from those in patients with idiopathic myasthenia gravis in terms of specificity and affinity. These patients had an increased prevalence of HLA Bw35 and DRi compared to controls and a decreased frequency of B8 and DR3 compared to patients with idiopathic myasthenia gravis. Likewise, they had a decreased frequency of DR4 compared to patients with rheumatoid arthritis","unstructured":"Antibodies to the acetylcholine receptor and HLA antigens have been studied in patients with myasthenia gravis occurring in association with penicillamine treatment. The properties of the antiacetylcholine receptor in these patients differed from those in patients with idiopathic myasthenia gravis in terms of specificity and affinity. These patients had an increased prevalence of HLA Bw35 and DRi compared to controls and a decreased frequency of B8 and DR3 compared to patients with idiopathic myasthenia gravis. Likewise, they had a decreased frequency of DR4 compared to patients with rheumatoid arthritis."}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.286.6362.337","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.286.6362.337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T20:12:07Z","timestamp":1765311127000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.286.6362.337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,1,29]]},"references-count":5,"journal-issue":{"issue":"6362","published-online":{"date-parts":[[1983,1,29]]},"published-print":{"date-parts":[[1983,1,29]]}},"alternative-id":["10.1136\/bmj.286.6362.337"],"URL":"https:\/\/doi.org\/10.1136\/bmj.286.6362.337","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1983,1,29]]}}}