Primary Sjögren Syndrome in a Child with a Neuromyelitis Optica Spectrum Disorder
Bibliographic record
Abstract
To the Editor: Neuromyelitis optica spectrum disorders (NMOSD) are a group of rare autoimmune diseases typically affecting women in their 40s and 50s, as does Sjögren syndrome (SS), another autoimmune disease. We describe a 6-year-old girl who presented with clinical and laboratory findings of both an NMOSD and SS. A 6-year-old previously healthy Korean girl presented with a 1-day history of fever, headache, progressive right-sided weakness, and altered mental status. Cerebrospinal fluid (CSF) analysis revealed an elevated protein without pleocytosis or oligoclonal bands. Magnetic resonance imaging (MRI) of the spinal cord showed contiguous T2 hyperintensity, and MRI of the brain showed extensive white matter lesions bilaterally (Figure 1), suspicious for demyelinating disease. She was treated with high-dose methylprednisolone, resulting in marked improvement, and continued treatment with tapering doses of prednisone, but flared when the prednisone was discontinued. Figure 1. A. MRI of the cervical and thoracic spine (T2 FLAIR with contrast shown) obtained at the onset of symptoms, prior to treatment. There is a contiguous hyperintense, centrally located spinal cord lesion. B. MRI of the head (T2 FLAIR with contrast shown) obtained at the … Address correspondence to Dr. G. Janow, Section of Pediatric Rheumatology, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, 30 Prospect Ave., WFAN Bldg. 3rd Floor, Hackensack, New Jersey 07601, USA. E-mail: GJanow{at}HackensackUMC.org
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.006 | 0.005 |
| 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".