Acquired blue sclerae in <scp>POEMS</scp> syndrome
Bibliographic record
Abstract
A 76-year-old woman developed progressive painful peripheral neuropathy and blue discolouration of the sclerae over one year. Physical examination revealed bilateral blue sclerae (image) and skin hyperpigmentation over the face and extremities, but no lymphadenopathy or hepatosplenomegaly. Laboratory investigations identified a monoclonal immunoglobulin G kappa paraprotein and elevated vascular endothelial growth factor. There was no evidence of endocrine dysfunction. Bone marrow biopsy showed involvement by clonal kappa-positive plasma cells. With a diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin changes) syndrome, she was treated with lenalidomide and dexamethasone, which halted but did not reverse symptom progression. Blue sclerae are commonly associated with congenital collagen synthesis disorders, such as osteogenesis imperfecta. Acquired blue sclerae have been described in adults with ocular melanosis, conjunctival melanoma, alkaptonuria and Addison disease. Common ocular manifestations in POEMS syndrome include papilloedema, blurred vision, diplopia and ocular pain.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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".