Athrombocytopenic thrombotic microangiopathy, a condition that could be overlooked based on current diagnostic criteria
Bibliographic record
Abstract
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) and haemolytic uraemic syndrome (HUS) are thrombotic microangiopathies (TMAs). They are generally diagnosed and treated by plasmapheresis in the presence of non-immune haemolytic anaemia and thrombocytopenia. Yet, many individuals admitted in our hospital for athrombocytopenic renal failure of unknown cause were reported to have TMA as main lesion on kidney biopsies. METHODS: Speculating that this presentation is not uncommon and that the underlying lesion might not be suspected because of current diagnostic criteria, we determined its prevalence and other accompanying features through a retrospective single-centre cohort of 50 cases where TMA had been identified histologically. RESULTS: At presentation, normal serum platelets were common (44%) but still accompanied by abnormal serum LDH in most subjects. End-stage renal disease and mortality at 5 years were also high especially in the athrombocytopenic group, but unrelated to the underlying aetiology of TMA. Importantly, several subjects in both groups received and apparently responded to plasmapheresis. CONCLUSION: In the absence of thrombocytopenia, TMA should still be contemplated when renal failure is associated with high serum LDH and its possible treatment with plasmapheresis assessed through prospective trials.
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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) | 0.001 | 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 | 0.000 | 0.000 |
| 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 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".