Bibliographic record
Abstract
OBJECTIVE: Here we report full autopsy results of a 27 year old male who initially developed an acute respiratory infection and subsequently developed hemorrhagic necrosis and edema in the right hemisphere of his brain secondary to acute hemorrhagic leukoencephalopathy. BACKGROUND: Acute Hemorrhagic leukoencephalopathy (AHLE) or Weston Hurst Syndrome is a rare, acute disorder characterized diffuse hemorrhagic necrosis of arterioles and/or by perivascular demyelination in the CNS. It is thought to represent a hyper-acute form of acute disseminated encephalomyelitis (ADEM). AHLE is relatively rare and has a very poor prognosis, with rapid deterioration and death usually occurring within days to one week after onset of symptoms. The cause for AHLE is unclear. RESULTS: We present brain histology results which showed punctate, ring shaped foci of perivascular hemorrhage and edema, localized to the white matter on H&E stain. This was surrounded by inflammation of both acute (neutrophil reaction) and chronic reaction (macrophages). There was multicentric fibrinoid necrosis within smaller arteriolar type vessels with surrounding edema noted in the right hemisphere. Post mortem CSF negative for mycoplasma pneumonia and Legionella by PCR. Cold Agglutinins were positive. Autopsy revealed active multifocal myocarditis, predominantly neutrophilic and a left lower lobe lung infection. CONCLUSIONS: The results thoroughly illustrate a severe post-infectious autoimmune reaction of a yet to be identified antigenic trigger leading to immune-complex deposition in walls of arterioles and venules which activates compliments and leads to vessel wall necrosis. The associated perivascular edema and/or demyelination ultimately led to death of the patient. The autopsy results confirmed lung infection and myocarditis. Given cold agglutinins were positive and the results of CXR showed atypical pneumonia, certainly mycoplasma pneumoniae is strongly suggested as the infectious cause in this case. This is the first case report strongly suggesting Mycoplasma pneumoniae as the cause for AHLE.
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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) | 0.000 | 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".