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
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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 | 0.001 | 0.004 |
| 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".