Successful Desensitization for Hydroxychloroquine Anaphylaxis
Bibliographic record
Abstract
To the Editor: Hydroxychloroquine (HCQ) is an antimalarial agent with immunosuppressive and cytotoxic properties. HCQ is a cornerstone in the treatment of systemic lupus erythematosus (SLE) and rheumatoid arthritis1,2. It has multiple beneficial effects. Exanthema/rash is the most common side effect. About 10% of patients treated with HCQ develop skin eruptions, some due to hypersensitivity. Other patterns of cutaneous hypersensitivity reactions have also been described with antimalarials1,2. Our patient, a 48-year-old man, had had as many as 11 attacks of pericarditis in less than 2 years, leading finally to a diagnosis of SLE. Once treatment with HCQ was initiated, there were no further attacks. He received treatment with HCQ over a period of 6 months with no notable incident. It was then necessary to interrupt the HCQ for approximately 2 weeks due to an intercurrent illness. Coinciding with resumption of treatment with HCQ 200 mg, he showed symptoms of anaphylaxis (blood pressure alterations, generalized urticaria, and chest pains) and required attention in the emergency room. He was referred to the Allergy Unit. Anaphylaxis due to HCQ was diagnosed, based on positive skin tests, and HCQ was stopped. On 3 occasions during the 3-month period when he was without treatment with HCQ, he required treatment using cycles of oral corticoids due to reappearance of pericarditis symptoms. He declined to take corticosteroids on a longterm basis although the progression of his pathology made this appear to be necessary. Faced with the negative … Address correspondence to Dr. C.D. Donado, Doctor Bellmunt s/n, Oviedo 33006, Asturias, Spain. E-mail: cdiazd{at}seaic.es
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.007 | 0.007 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".