Systemic Capillary Leak Syndrome Should be Considered in the Differential Diagnosis of Multi-Organ Failure and Hypovolemic Shock
Bibliographic record
Abstract
Reply: As we stated in our case report, the rarity of parainfluenza virus infection-associated rhabdomyolysis leading to compartment syndrome and renal failure makes identifying “commonly” associated findings that could suggest a unifying underlying pathogenesis difficult. The suggestion by S. Kahn of “Systemic Capillary Leak Syndrome” (SCLS) represents a welcome unifying theory. However, while SCLS could have played a role in the clinical presentation of our case, SCLS itself is the result of an underlying dysregulated inflammatory response, thus represents an effect, not a cause. However, the cases of repeated SCLS that Kahn cites are of special interest in this regard. Our patient has had a second episode of rhabdomyolysis, compartment syndrome, and renal failure associated with a febrile illness. Her second episode was likely triggered by H1N1 infection. Repeat episodes triggered by viral infections suggest a possible underlying genetic predisposition. Genetic screening of these rare repeat cases for potentially associated genetic polymorphisms could eventually provide the unifying answer that we are looking for. Regan Lorraine Ebbeson, MD British Columbia's Children's Hospital Tobias R. Kollman, MD, PhD British Columbia's Children's Hospital Vancouver, Canada
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".