Nodulosis in Systemic Onset Juvenile Idiopathic Arthritis: An Uncommon Event with Spontaneous Resolution
Bibliographic record
Abstract
Accelerated nodulosis is a rare complication of methotrexate therapy in juvenile idiopathic arthritis. When nodulosis does occur in patients with juvenile idiopathic arthritis on methotrexate, it is almost always seen in patients with polyarthritis with rheumatoid factor seropositivity, but only occasionally in polyarthritis patients who are rheumatoid factor negative. It has been described previously in only one patient with systemic arthritis. In this study, we describe three patients with systemic arthritis, all of whom developed nodulosis while receiving methotrexate. Interestingly, it was not necessary to discontinue methotrexate in any of these patients. In fact, methotrexate dose was escalated without consequences and with complete resolution of nodules. This observation suggests that nodulosis occurring in patients with systemic arthritis already on methotrexate may not be because of methotrexate itself, but may be a component of the disease process. The other likely possibility given the fact that nodulosis occurs with other immunomodulatory agents and is not specifically related to methotrexate is that immunomodulatory agents in general precipitate the development of nodulosis. Thus, we propose that the new terminology "immunomodulatory agents induced nodulosis" rather than "methotrexate-induced nodulosis" be used in the literature.
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".