002. BREAKING BAD IN SUBURBIA: A CASE OF DRUG-INDUCED VASCULITIS
Notice bibliographique
Résumé
Background: Levamisole is a synthetic compound used as an anthelmintic. It has been found in adulterated cocaine linked with ANCA associated vasculitis. Methods: This is the case of a 58-year-old male presented to accident and emergency with dysphasia. A stroke was suspected and an urgent CT head scan, demonstrated a lacunar infarct. He was commenced on aspirin 300mg, clopidogrel 75mg, lansoprazole 30mg, and Atorvastatin 40mg. His secondary risk factors included hypertension, obesity and a smoking history. Blood tests at the time of admission demonstrated stage three chronic kidney disease and protein and blood on urine dip. A full nephritic screen was performed. ANCA was positive in a cytoplasmic pattern, with a positive PR3 of 72U/ml. Urine demonstrated 122 red blood cells but no casts. There was an unfortunate delay of six weeks before renal review. A kidney biopsy was conducted which demonstrated advanced scarring of his kidneys with obsolete glomeruli, however there was still activity in one crescent. A diagnosis of C-ANCA positive renal vasculitis was given and he was commenced on Prednisolone 60mg and Adcal D3. An urgent referral to rheumatology was made for consideration for IV cyclophosphamide. The rheumatology consultation elicited a history of long-standing poor memory, which appears to have predated his stroke. His MRI subsequent to his stroke showed involvement of the left corona radiate, discrete focus on the right, with additional hyper-intense foci scattered within the white matter of both cerebral hemispheres. Review of CT and MRI scans demonstrated evidence of very significant paranasal sinus disease. There was some evidence of bony destruction including the medial orbital wall on the right and some thickening of the medial extra-ocular muscle. There was increased signal at the same site on the MRI. Surprisingly he denied any nasal symptoms. He admitted otherwise of some wheeze in the chest since the stroke but there were no other neurological symptoms, no hearing symptoms and he denied any constitutional symptoms. There was a history of DVT 4 years previously and a 10yr history of cocaine abuse up until the time of his stroke. He was diagnosed granulomatosis with polyangitis. The cocaine abuse we believe may have played a role in induction of his disease. Treatment plan currently is for 6 cycles of cyclophosphamide, reducing dose prednisolone with plans for Azathioprine as a DMARD in the future.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».