Polyserositis in a Patient with Active Systemic Lupus Erythematosus: A Case of Pseudo-pseudo Meigs Syndrome
Bibliographic record
Abstract
A 40-year-old woman was diagnosed with systemic lupus erythematosus (SLE) 10 years ago, manifesting with edematous hands, Raynaud phenomenon, livedo reticularis, arthralgias/arthritis of hand joints, and lymphadenopathy, without renal involvement. Laboratory and serological findings included chronic disease anemia, leukopenia, and diffuse hypergammaglobulinemia; positive antinuclear, anti-Sm, anti-Ro (Ro52 and Ro60), and increased anti-dsDNA antibodies; and hypocomplementemia. For the last 2 years, she was in remission under methylprednisolone 4 mg/day, azathioprine 100 mg/day, and hydroxychloroquine 200 mg/day. Two months before presentation, feeling inundated by the chronicity of her disease and treatment, she discontinued all medication. Upon presentation, she was unwell and dyspneic, and had intense livedo of lower extremities, Raynaud phenomenon, edematous hands with arthritis, and a distended abdomen. Breathing sounds of the left lung base were reduced. There was no pericardial friction rub or pulsus paradoxus, and echocardiography revealed a nonhemodynamically relevant pericardial effusion. Chest and abdominal computed tomography showed, in addition to the pericardial effusion, a unilateral pleural effusion (Figure 1A) and massive ascites (Figure 1B). Remarkable laboratory tests included elevated C-reactive protein [CRP; 30 mg/l, normal value (nv) < 5 mg/l], diffuse … Address correspondence to Dr. E. Zampeli, Institute for Autoimmune Systemic and Neurological Disorders, M. Asias 75, 11527, Athens, Greece. E-mail: zampelieva{at}gmail.com
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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".