A Case of Severe Hypernatremic Myopathy by Primary Hypodipsia, Hyperglycemic Hypertonic State in a 17-Year-Old Patient With Mental Retardation
Bibliographic record
Abstract
Although severe hypernatremia, defined as a sodium concentration > 180 mEq / L, is associated with a high mortality rate, particularly in adults, little is known about severe hypernatremia in patients with diabetic ketoacidosis (DKA). Hypernatremic myopathy has been reported in patients with severe dehydration, acute kidney injury, and rhabdomyolysis. Dehydration in a diabetic patient with mental retardation may be caused by osmotic diuresis and exacerbated by hypodipsia, which requires the patient to be educated about regular oral hydration. Here, we describe a 17-year-old patient with reversible severe hypernatremia (serum corrected sodium, 180 mEq / L) and primary hypodipsia, but without DKA. The patient visited the emergency room due to agitation and weakness in both lower extremities. Initial laboratory tests showed hyperglycemia, acute kidney injury, acute hepatitis, and myopathy. Following rehydration with one-quarter isotonic saline and intensive insulin therapy, the patient ’ s symptoms (including leg weaknesses) and laboratory findings improved. doi: http://dx.doi.org/10.4021/jmc1136w
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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 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 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".