Hepatosplenic Lymphoma Presenting Initially as Hemophagocytic Syndrome in a 21-Year-Old Man with Crohn’s Disease: A Case Report and Brief Literature Review
Bibliographic record
Abstract
T he present report describes a case involving a 21-year-old man diag- nosed with Crohn's disease 10 years previously.A diffuse mild to moderate colitis was found at colonoscopy.Different treatments based on 5-aminosalicylic acid, prednisone, methotrexate and purinethol were attempted but did not induce remission.Five years later, a combination of purinethol 25 mg per day and infliximab 350 mg every six to seven weeks proved to be successful.Four years later, the patient was admitted to hospital with fever (39°C) and bicytopenia, without any gastrointestinal symptoms.A complete blood panel revealed the following: white blood cell count (Wbc) 0.9×10 9 /L (neutrophils 0.2×10 9 /L), a hemoglobin level of 156 g/L and a platelet count of 105×10 9 /L.The final doses of purinethol and infliximab were given one month before admission.A bone marrow biopsy was performed and showed hemophagocytic syndrome (Figure 1A).Epstein-Barr virus (EBV) serology (viral capsid antigen [VCA] immunoglobulin [Ig] M and EBV nuclear antigen [EBNA] IgG) was negative and an abdominal computed tomography scan showed mild hepatosplenomegaly.The patient evolved well clinically and the blood count normalized with filgrastim (Neupogen [Amgen Inc, USA]).One week later, the patient's blood count showed pancytopenia (Wbc 2.1×10 9 /L, neutrophils 0.1×10 9 /L, hemoglobin level of 133 g/L and a platelet count of 42×10 9 /L) presenting with abdominal pain.A distal endoscopy showed mild proctitis.Due to the pancytopenia, no treatment was started.EBV serology was positive for EBNA IgG and negative for VCA IgM.No antiviral treatment was started.He was discharged, and outpatient chemotherapy with dexamethasone, etoposide and cyclosporin A (hemophagocytic lymphohistiocytosis -2004 protocol) was initiated.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".