Autoimmune pulmonary alveolar proteinosis with progressive fibrosis refractory to treatment with whole lung lavage, inhaled GM-CSF and rituximab
Bibliographic record
Abstract
Pulmonary fibrosis occurs in up to 30% of patients with pulmonary alveolar proteinosis, and pulmonary hypertension is rarely identified. A previously healthy, highly active, asymptomatic 59-year-old male was diagnosed with autoimmune pulmonary alveolar proteinosis. He was followed clinically for five years until he developed disease progression with dyspnea on exertion. In the interim, he had developed pulmonary fibrosis, and was later found to have pulmonary hypertension. He continued to decline despite aggressive treatment with whole-lung lavage, inhaled granulocyte-macrophage colony-stimulating factor, and rituximab and now has very limited activity, despite use of supplemental oxygen. Pulmonary fibrosis and pulmonary hypertension are uncommon and unpredictable complications of pulmonary alveolar proteinosis. Current treatment regimens for pulmonary alveolar proteinosis may not benefit patients once fibrosis is established. It is not known whether early aggressive treatment can stabilize or delay disease progression.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| 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".