Late-onset acute haemorrhagic necrotizing granulomatous adenovirus tubulointerstitial nephritis in a renal allograft
Bibliographic record
Abstract
(Section Editor: A. Meyrier) Adenovirus (AV) is a relatively common infection in solid organ transplant recipients, and has a wide clinical presentation and outcome, ranging from subclinical and self-limiting to lethal disease. In renal transplant patients, symptomatic AV infection presents with tubulointerstitial nephritis, acute haemorrhagic cystitis, pneumonia or fatal disseminated viral disease. Most often, AV infection occurs within weeks to months after transplantation, suggesting reactivation of a latent AV in the immunosuppressed recipient as the source of infection. This report describes an unusual case of AV infection in the native lung but also in the renal allograft, 12 years after transplantation. The patient presented with gross haematuria, pain over the kidney allograft, fever and acute renal failure. The late onset of infection suggested de novo infection in an immunosuppressed patient rather than activation of latent infection or donor-origin infection. Renal biopsies showed severe haemorrhagic necrotizing granulomatous tubulointerstitial nephritis. Viral cytopathic changes were present in tubular epithelial cell nuclei, but since the more common polyomavirus immunostaining was negative, a diagnosis of viral infection was not made at the time. The late onset of infection, the presence of a well-defined granulomatous reaction, and the under recognition of adenovirus infection made the clinicopathological diagnosis difficult.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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) | 0.000 | 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".