Catastrophic Antiphospholipid Syndrome and Polyarteritis Nodosa
Bibliographic record
Abstract
The catastrophic antiphospholipid syndrome (CAPS) is a rare and severe manifestation of the antiphospholipid syndrome (APS)1. We describe a case with features of both CAPS and polyarteritis nodosa (PAN), described only once previously in the literature. A healthy 66-year-old man presented to an outside institution with progressive bilateral myalgias in his arms and lower legs. He reported fatigue and a 10-lb unintentional weight loss over the preceding month, but denied other symptoms or exposures. Blood pressure was 140/91 mm Hg, elevated from 120/70 mm Hg recorded 3 weeks earlier. He had cool, pale feet with diminished sensation and limited range of motion. Popliteal pulses were palpable, but dorsalis pedis and posterior tibial pulses were not detectable by Doppler ultrasound. The remainder of the examination was normal. Hemoglobin was 109 g/l with mean corpuscular volume 87 fl, white blood cell count 31.6 × 109/l, (neutrophils 29 × 109/l), and platelets 967 × 109/l. Albumin was 29 g/l and creatinine 71 mmol/l. Coagulation measures were normal. Lupus anticoagulant was positive. Testing was done by an activated partial thromboplastin time assay, mixing studies, and a dilute Russell venom viper test, and confirmatory testing was performed. Aspartate aminotransferase was 107 U/l, alanine aminotransferase (ALT) 142 U/l, gamma-glutamyl transferase 52 U/l, and alkaline phosphatase 152 U/l. Creatine kinase was 1317 U/l and … Address correspondence to Dr. Khalidi; E-mail: naderkhalidi{at}sympatico.ca
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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 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".