VIP-Secreting Ganglioneuroblastoma as an Unusual Cause of Watery Diarrhoea in Childhood
Bibliographic record
Abstract
A 15-month-old boy with a 2-month history of watery diarrhoea presented with cachexia, hypokalaemia, hypochloraemia and metabolic acidosis. During a 2-week investigation period infection, celiac disease and cystic fibrosis were excluded and trial therapy with antibiotics, probiotics and dietary measures proved unsuccessful. This led to the suspected diagnosis of a vasoactive intestinal polypeptide (VIP)-secreting tumour with watery diarrhoea, hypokalaemia, achlorhydria (WDHA)-syndrome. MRI showed an infrarenal mass infiltrating the neuroforamen, which on pathological examination was consistent with a VIP-secreting neuroganglioblastoma. Serum VIP and urinary catecholamine levels were elevated. Treatment consisted of 2 courses of chemotherapy and a partial resection of the tumour, following which the diarrhoea disappeared. Refractory watery diarrhoea that persists during fasting in a young child should alert to the diagnosis of WDHA, and prompt investigations to diagnose a VIP-secreting tumour, one of the most common causes of secretory diarrhoea in the developed world. Timely diagnosis could avoid morbidity due to unnecessary investigations and protracted diarrhoea. doi: http://dx.doi.org/10.4021/jmc1009w
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| 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".