Duodenal vascular ectasia (DUVE) associated with hematopoietic stem cell transplant
Bibliographic record
Abstract
A 63-year-old man post hematopoietic stem cell transplantation (HSCT) developed significant gastrointestinal bleeding with melena and drops in hemoglobin that required multiple blood transfusions. He had received fludarabine and busulfan for pretransplantation conditioning. Esophagogastroduodenoscopy (EGD) on day 89 post transplantation (+ 89) revealed an antral-limited portal hypertensive gastropathy (PHG) and duodenopathy that involved the bulb and second part of the duodenum; the findings were also compatible with gastric antral vascular ectasia (GAVE) ([Fig. 1]). Several subsequent EGDs due to ongoing blood loss all confirmed antral limited PHG. Severe hemorrhagic gastritis and duodenitis consistent with GAVE ([Fig. 2]) was seen on day + 132. The final endoscopy (day + 203) showed GAVE throughout the stomach and duodenum, gastric varices, and small esophageal varices. The genesis of these varices was cryptogenic as there was no evidence of either portal hypertension or a splenic vein thrombosis. Treatment for the patient included intravenous/per oral proton pump inhibitors and one treatment of argon plasma coagulation, which did not affect the ongoing blood loss significantly. A transjugular, intrahepatic portosystemic shunt was placed (day + 231) due to recurrent bleeding. Unfortunately, the patient died due to overwhelming sepsis and continued bleeding (day + 253). Duodenal biopsies from earlier in the admission were revisited post mortem and felt to be consistent with vascular ectasia ([Fig. 3]).
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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".