Refractory Syndrome of Inappropriate Secretion of Antidiuretic Hormone in Systemic Lupus Erythematosus–associated Hypophysitis
Bibliographic record
Abstract
To the Editor: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported in diseases involving the central nervous system (CNS). However, SIADH is rarely reported in patients with systemic lupus erythematosus (SLE)1,2,3,4,5,6. We present a case of a 34-year-old woman with a history of SLE who was diagnosed with SLE in 2009 with polyarthritis, leukopenia, oral ulcers, alopecia, photosensitive rash, diffuse proliferative glomerulonephritis, positive antinuclear antibody, and elevated dsDNA. Two months prior to presentation, she was transitioned from mycophenolate mofetil (MMF) 500 mg bid to azathioprine (AZA) 50 mg daily because of the desire to attempt conception. One month later, she started having daily fevers, sore throat, photosensitive rash, tender posterior cervical lymphadenopathy, abdominal pain, and leukopenia. Because of the leukopenia, she was switched from AZA back to MMF. Her worsening leukopenia and elevated inflammatory markers were suggestive of an SLE flare and she was given a higher dose of prednisone. One month later, she developed abdominal pain, nausea, and vomiting. Her medications included … Address correspondence to Dr. N. Yang, 60 Fenwood Road, Suite 3032X, Boston, Massachusetts 02115, USA. E-mail: nyang2{at}partners.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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| 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".