Early Therapeutic Intervention for IgG4-related Dacryoadenitis and Sialadenitis: The Balance Between Risk of Observation Only and Therapeutic Adverse Effects
Bibliographic record
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic, chronic, and fibroinflammatory disorder1,2. Some problems remain to be resolved in IgG4-RD. We consider here the indication of therapeutic intervention for IgG4-RD. The correct time to initiate treatment remains unclear. Prescription of glucocorticoids is recommended for patients with clinical symptoms such as abdominal pain and obstructive jaundice, or other organ involvement in autoimmune pancreatitis3. One of the reasons is that such lesions show spontaneous improvement, although the frequency is low. We have previously reported steroid treatment for patients having IgG4-related sialadenitis more than 2 years, but that failed to improve salivary gland function4. We concluded that delayed therapeutic intervention in those cases had progressed to irreversible fibrosis in the involved organs. We have mainly treated IgG4-related dacryoadenitis and sialadenitis (IgG4-DS) in our department. This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. All study-related recruitment and procedures were approved by the Sapporo Medical University Hospital Institutional Review Board (282-205). Participants provided written informed consent for … Address correspondence to Dr. M. Yamamoto, Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South 1 West 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan. E-mail: mocha{at}cocoa.plala.or.jp
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".