Anorexia nervosa in a patient with congenital adrenal hyperplasia
Bibliographic record
Abstract
Life stressors and hormonal dysregulation in the hypothalamic-pituitary-adrenal (HPA) axis are common factors that play a role in both anorexia nervosa (AN) and congenital adrenal hyperplasia (CAH). The complexity of combined CAH and AN on the HPA axis has not, to our knowledge, been previously illustrated. We present a report of an adolescent with CAH who developed AN, requiring hospitalized management. We use this case to review the pathophysiology of CAH and AN as it relates to the stress response and hormonal dysregulation within the HPA axis. We then highlight the interplay between these conditions, and provide support to the theory that AN acts as a chronic stressor in patients with CAH, leading to HPA axis hyperactivity and elevated levels of androgen precursors. It is prudent for the medical team to monitor and modify CAH steroid dosing during the acute phase of AN, weaning appropriately with AN treatment success.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".