Calcium Pyrophosphate Crystal Inflammatory Arthritis (Pseudogout) with Myelodysplastic Syndrome: A New Paraneoplastic Syndrome?
Bibliographic record
Abstract
To the Editor: Calcium pyrophosphate (CPP) deposition in articular tissue causes a spectrum of clinical presentations including asymptomatic chondrocalcinosis, acute CPP crystal arthritis (pseudogout), and chronic CPP inflammatory arthritis1. Known risk factors include older age, osteoarthritis, prior joint injury, metabolic disease, and rarely, family history2. Myelodysplastic syndromes (MDS) are a clinically and genetically heterogeneous group of stem cell disorders generally characterized by hypercellular bone marrow and peripheral cytopenias3. Prognosis depends on comorbidities and disease factors including number of cytopenias, specific chromosomal abnormalities, and degree of marrow blast infiltration [5%–9%, 10%–19%, and ≥ 20% represent refractory anemia with excess blasts (RAEB)-1, RAEB-2, and acute myeloid leukemia (AML), respectively]4. The patient died before our case report was prepared, and thus we were not able to obtain his written consent to publish the material; however, while he was alive we discussed our plan to prepare this case report and he was in agreement. Our patient was a 75-year-old man who developed dyspnea in October 2015. Anemia and leukopenia were noted, and bone marrow biopsy revealed hypercellular marrow with 10% blasts consistent with RAEB-2. A very complex/monosomal karyotype including loss of chromosome 17 was noted. … Address correspondence to Dr. S.K. Tedeschi, Brigham and Women’s Hospital, Division of Rheumatology, 75 Francis St., Boston, Massachusetts 02115, USA. E-mail: stedeschi1{at}bwh.harvard.edu
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 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".