Bibliographic record
Abstract
Dear Sir, We thank Ben Sprangers and Kathleen Claes for their valuable comment on our case report ‘Hypocomplementaemic immune complex tubulointerstitial nephritis’ [1]. We agree that immunoglobulin G4 (IgG4)-related systemic disease is a potential differential diagnosis in our case. Predominant male disease, autoimmune immune complex nature, low complements, positive antinuclear antibody (ANA), tubulointerstitial involvement and good response to steroids remain common features [2,3]. Unfortunately, immunoglobulin levels, in particular IgG4, and specific tissue staining for IgG4 were not measured and done in our case. It is the same scenario for previously reported cases of hypocomplementaemic idiopathic immune complex tubulointerstitial nephritis (TBIN) that we mentioned in our case report [1,2]. In the absence of this evidence, presence or absence of IgG4 disease in reference to our case remains a speculation. On reviewing the literature of IgG4 disease, we noted some important differences. Most of the cases of IgG4 disease have concurrent or subsequent systemic involvement [3]. On the contrary, there was no evidence of systemic or extrarenal disease in our case even after a follow-up of 18 months [1]. In the largest reported series of cases of hypocomplementaemic idiopathic immune complex TBIN by Kambham et al., there were two cases of sclerosing cholangitis which could be potentially indicative of IgG4 disease [2]. However, autoimmune pancreatitis, which is one of the most commonly reported features of IgG4 disease, was conspicuous by its absence in all the reported cases of idiopathic TBIN [1–3]. Also, no significant glomerular disease has been reported in cases of idiopathic TBIN, while membranous and membranoproliferative glomerulonephritis have been reported with IgG4 disease [1,2,4,5]. We could not find any reported case of IgG4 disease with tubulointerstitial nephritis and no extrarenal involvement. There are cases described without pancreatitis, but even they have some extrarenal involvement in terms of sialadenitis and lymphadenopathy [6]. In conclusion, it is difficult to say whether our case has IgG4 disease as aetiology due to lack of IgG4 levels and tissue staining and in the light of available literature. Conflict of interest statement. None declared.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.037 | 0.037 |
| Insufficient payload (model declined to judge) | 0.020 | 0.014 |
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".