Bibliographic record
Abstract
A 40 year old woman with recurrent “idiopathic” anaphylaxis was referred. Past history revealed a right ovarian mucinous cyst adenoma that was surgically removed. Medications included celebrex and alesse. Six months following the oopherectomy at age 15, she began to experience anaphylaxis every 2 months. Typically these occurred in late afternoon, not on an empty stomach, and half related to physical activity. During three reactions she self administered epinephrine that led to improvement within minutes. She had one biphasic reaction. She did recall being stung by a vespid but was asymptomatic. Her two – three hour reactions consisted of abdominal pain, nausea, vomiting, diarrhea, weakness, pruritis with flushing, and documented hypotension. Occasionally, there was nasal congestion, stridor, palpatations, presyncope. On two occasions she had syncope. There were no triggers including cholinergic, foods, and catamenial. Physical examination was unremarkable. She neither had Darier’s sign nor urticaria pigmentosa. Skin prick testing to common allergens was negative. Her serum tryptase was 8.3 ug/L. Tryptase immediately after a reaction was 33 ug/L. Normetanephrines, metanephrines, vanillymandelic acid, 5-hydroxyindoleacetic acid, 24 hour urine catecholamines for noradrenaline and dopamine, serum chromogranin A and calcitonin were all normal. Her CT abdomen and pelvis was normal. She continued to have episodes on ranitidine 150mg and ketotifen 4mg twice daily as well as cetirizine 20mg and singulair 10mg once daily. On bone marrow biopsy she met three WHO minor criteria for systemic mastocytosis: greater than 25% mast cells having cytologically atypical hypogranular spindle shapes; flow cytometry showing positive aberrant co-expression of CD25 and CD2 on mast cells; and mutational analysis of the c-kit gene being positive for the D816V C-KIT mutation. Tryptase at bone marrow aspiration was 7.6ug/L. In patients with idiopathic anaphylaxis, consider a bone marrow biopsy for systemic mastocytosis in spite of a negative physical exam and normal tryptase.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| 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 | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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".