Coexistence of Intrahepatic Cholestasis of Pregnancy Accompanied by Hepatitis B Flare in a Pregnant Woman and the Subsequent Development of Postpartum Thyroiditis and HBS Antigen Loss: A Case Report
Bibliographic record
Abstract
A 23-year-old pregnant woman was admitted to our hospital due to pruritus and right upper quadrant pain. Her abdominal ultrasound revealed hepatomegaly and the fetal ultrasonography was normal. Her HBS antigen was positive and HBe antigen was negative. HBV-DNA level was 350,000 copies / ml. Coincidental hepatobiliary diseases in pregnancy were ruled out. The patient received a diagnosis of HBe antigen negative hepatitis B and tenofovir disoproxil 245 mg / day was prescribed. At a follow-up visit one month later, she reported no improvement in her pruritus. The levels of liver transaminases were near-normal and HBV DNA was zero. However, her biochemistry revealed raised alkaline phosphatase and gamma glutamyl transferase levels. Her consecutively calculated fasting serum bile acid levels were too high. A diagnosis of severe intrahepatic cholestasis of pregnancy associated with hepatitis B infection was made and a treatment of ursodeoxycholic acid 1000 mg / day was prescribed while she continued to take tenofovir disoproxil. She had a normal delivery and there were no adverse outcomes for the fetus. Several weeks later, she was readmitted with tremor and nervousness. Her TSH level was low and CRP level was high. The rest of the laboratory findings were normal and an ultrasonography of thyroid showed paranchymal heterogenity. The aggregate of findings was consistent with postpartum thyroiditis. Finally, L-thyroxine was initiated on a daily basis. Interestingly, at the week of 96, loss of Hepatitis B surface antigen was detected during tenofovir treatment. doi:10.4021/jmc594w
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".