{"id":"https://openalex.org/W2947063569","doi":"https://doi.org/10.1056/nejmcps1807619","title":"A Disturbing Decline","display_name":"A Disturbing Decline","publication_year":2019,"publication_date":"2019-06-05","ids":{"openalex":"https://openalex.org/W2947063569","doi":"https://doi.org/10.1056/nejmcps1807619","mag":"2947063569","pmid":"https://pubmed.ncbi.nlm.nih.gov/31167056"},"language":"en","primary_location":{"id":"doi:10.1056/nejmcps1807619","doi":"https://doi.org/10.1056/nejmcps1807619","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejmcps1807619","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5069300441","display_name":"David A. Braun","orcid":"https://orcid.org/0000-0003-4543-5553","observed_orcids":["https://orcid.org/0000-0003-4543-5553"]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"David A. Braun","raw_affiliation_strings":["From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","Departments of Medicine, Brigham and Women's Hospital, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Departments of Medicine, Brigham and Women's Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109888671","display_name":"Galen V. Henderson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Galen V. Henderson","raw_affiliation_strings":["From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","Neurology, Brigham and Women's Hospital, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Neurology, Brigham and Women's Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000473129","display_name":"Paul Edward Sax","orcid":"https://orcid.org/0000-0001-8434-174X","observed_orcids":["https://orcid.org/0000-0001-8434-174X"]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Paul E. Sax","raw_affiliation_strings":["From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","Departments of Medicine, Brigham and Women's Hospital, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Departments of Medicine, Brigham and Women's Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5072901982","display_name":"Amy Leigh Miller","orcid":"https://orcid.org/0000-0001-6685-3848","observed_orcids":["https://orcid.org/0000-0001-6685-3848"]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Amy L. Miller","raw_affiliation_strings":["From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","Departments of Medicine, Brigham and Women's Hospital, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Departments of Medicine, Brigham and Women's Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5028396638","display_name":"Joseph Loscalzo","orcid":"https://orcid.org/0000-0002-1153-8047","observed_orcids":["https://orcid.org/0000-0002-1153-8047"]},"institutions":[{"id":"https://openalex.org/I1283280774","display_name":"Brigham and Women's Hospital","ror":"https://ror.org/04b6nzv94","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I121934306","https://openalex.org/I1283280774","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Joseph Loscalzo","raw_affiliation_strings":["From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","Departments of Medicine, Brigham and Women's Hospital, Boston"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"From the Departments of Medicine (D.A.B., P.E.S., A.L.M., J.L.) and Neurology (G.V.H.), Brigham and Women\u2019s Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]},{"raw_affiliation_string":"Departments of Medicine, Brigham and Women's Hospital, Boston","institution_ids":["https://openalex.org/I1283280774"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I1283280774"],"apc_list":null,"apc_paid":null,"fwci":0.3787,"has_fulltext":false,"cited_by_count":3,"citation_normalized_percentile":{"value":0.60938334,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":94},"biblio":{"volume":"380","issue":"23","first_page":"2257","last_page":"2262"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.7788000106811523,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.7788000106811523,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13533","display_name":"Medical Case Reports and Studies","score":0.05900000035762787,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10981","display_name":"Cytomegalovirus and herpesvirus research","score":0.03189999982714653,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/systemic-lupus-erythematosus","display_name":"systemic lupus erythematosus","score":0.9950000047683716},{"id":"https://openalex.org/keywords/diarrhea","display_name":"diarrhea","score":0.8289999961853027},{"id":"https://openalex.org/keywords/gastrointestinal-manifestations-of-lupus","display_name":"gastrointestinal manifestations of lupus","score":0.6380000114440918},{"id":"https://openalex.org/keywords/fever","display_name":"fever","score":0.6700000166893005},{"id":"https://openalex.org/keywords/myalgia","display_name":"myalgia","score":0.8399999737739563},{"id":"https://openalex.org/keywords/nausea-and-vomiting","display_name":"nausea and vomiting","score":0.6299999952316284}],"concepts":[{"id":"https://openalex.org/C2778594517","wikidata":"https://www.wikidata.org/wiki/Q2260058","display_name":"Chills","level":2,"score":0.9633408784866333},{"id":"https://openalex.org/C2779277585","wikidata":"https://www.wikidata.org/wiki/Q2673323","display_name":"Malaise","level":2,"score":0.9614785313606262},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9257054328918457},{"id":"https://openalex.org/C2780852908","wikidata":"https://www.wikidata.org/wiki/Q127076","display_name":"Vomiting","level":2,"score":0.8599525690078735},{"id":"https://openalex.org/C2780580376","wikidata":"https://www.wikidata.org/wiki/Q186889","display_name":"Nausea","level":2,"score":0.8326348066329956},{"id":"https://openalex.org/C2779802037","wikidata":"https://www.wikidata.org/wiki/Q40878","display_name":"Diarrhea","level":2,"score":0.7172894477844238},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3907076120376587},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3369407653808594},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.33222872018814087},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.24722042679786682}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001921","descriptor_name":"Brain","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":false},{"descriptor_ui":"D003937","descriptor_name":"Diagnosis, Differential","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003967","descriptor_name":"Diarrhea","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006561","descriptor_name":"Herpes Simplex","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008180","descriptor_name":"Lupus Erythematosus, Systemic","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":false},{"descriptor_ui":"D008181","descriptor_name":"Lupus Nephritis","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D008279","descriptor_name":"Magnetic Resonance Imaging","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008590","descriptor_name":"Meningoencephalitis","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D008590","descriptor_name":"Meningoencephalitis","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D014901","descriptor_name":"West Nile Fever","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D014901","descriptor_name":"West Nile Fever","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D014902","descriptor_name":"West Nile virus","qualifier_ui":"Q000302","qualifier_name":"isolation & purification","is_major_topic":false},{"descriptor_ui":"D016867","descriptor_name":"Immunocompromised Host","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018258","descriptor_name":"Herpesvirus 2, Human","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1056/nejmcps1807619","doi":"https://doi.org/10.1056/nejmcps1807619","is_oa":false,"landing_page_url":"https://doi.org/10.1056/nejmcps1807619","pdf_url":null,"source":{"id":"https://openalex.org/S62468778","display_name":"New England Journal of Medicine","issn_l":"0028-4793","issn":["0028-4793","0096-6762","1533-4406","2331-4710"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320239","host_organization_name":"Massachusetts Medical Society","host_organization_lineage":["https://openalex.org/P4310320239"],"host_organization_lineage_names":["Massachusetts Medical Society"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"New England Journal of Medicine","raw_type":"journal-article"},{"id":"pmid:31167056","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/31167056","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The New England journal of medicine","raw_type":"Case Reports"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9922999739646912,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":15,"referenced_works":["https://openalex.org/W112439151","https://openalex.org/W1521715232","https://openalex.org/W2018810796","https://openalex.org/W2037484801","https://openalex.org/W2041005483","https://openalex.org/W2046317171","https://openalex.org/W2086689088","https://openalex.org/W2113136129","https://openalex.org/W2124180846","https://openalex.org/W2156209411","https://openalex.org/W2159039576","https://openalex.org/W2160780170","https://openalex.org/W2329413583","https://openalex.org/W2789856846","https://openalex.org/W2916575479"],"related_works":["https://openalex.org/W6903604218","https://openalex.org/W2977305827","https://openalex.org/W7213756071","https://openalex.org/W4386758355","https://openalex.org/W4403099816","https://openalex.org/W2741432005","https://openalex.org/W7212050685","https://openalex.org/W7125590722","https://openalex.org/W2777950544","https://openalex.org/W1975023515"],"abstract_inverted_index":{"A":[0],"29-year-old":[1],"woman":[2],"with":[3,11],"a":[4],"history":[5],"of":[6],"systemic":[7],"lupus":[8],"erythematosus":[9],"presented":[10],"diarrhea":[12],"that":[13],"had":[14,21],"been":[15,23],"ongoing":[16],"for":[17],"several":[18],"days":[19],"and":[20,27,36],"initially":[22],"accompanied":[24],"by":[25],"nausea":[26],"vomiting.":[28],"She":[29],"also":[30],"reported":[31],"fever,":[32],"chills,":[33],"diffuse":[34],"myalgias,":[35],"malaise.":[37]},"counts_by_year":[{"year":2025,"cited_by_count":1},{"year":2021,"cited_by_count":1},{"year":2019,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2019-06-07T00:00:00"}
