A264 CLINICAL, ENDOSCOPIC, AND HISTOPATHOLOGIC FEATURES OF GASTROINTESTINAL DISEASE IN COMMON VARIABLE IMMUNODEFICIENCY.
Bibliographic record
Abstract
Patients with common variable immunodeficiency (CVID) disorder are reported to have a significant burden of infectious and inflammatory gastrointestinal (GI) diseases. Currently, the clinical, endoscopic, and histopathologic characteristics of GI disease among CVID patients is not well described. This study aims to characterize the clinical, endoscopic, and histopathologic profile of GI pathology in a large cohort of CVID patients from a tertiary care centre. We included all CVID patients at St. Michael’s Hospital from January 1, 2000 to May 31, 2018. For each patient, we collected the age of CVID diagnosis, and age of onset of gastrointestinal symptoms. We collected the following clinical data at the time of onset of gastrointestinal symptoms: presence of abdominal pain, bowel movement changes, weight loss, nausea/vomiting, and bloating, history of gastrointestinal disease such as IBD or coeliac disease, treatments offered for GI symptoms, and gastrointestinal infections. We also collected endoscopic, histopathologic, and laboratory data, including immunoglobulin trough levels, at the date nearest to the onset of gastrointestinal symptoms, within three months. We used descriptive statistics to characterize patients with CVID, and compared patients with and without gastrointestinal symptoms using non-parametric tests for continuous variables and Fisher’s exact test for categorical variables. We included 95 patients with CVID. The mean age of patients at the time of CVID diagnosis was 38.2(±16.0). Fifty-three (56%) patients were female. Sixty-four (67%) patients had GI symptoms, with a mean age of onset for GI symptoms of 43.4(±15.1) years. The most common symptoms were bowel movement changes (n=55 [58%]) and abdominal pain (n=44 [46%]). Patients with GI symptoms were more likely to have anaemia (n=23 [36%] vs. n=3 [10%], p<0.05), iron deficiency (n=16 [25%] vs. n=2 [7%], p<0.05), and have received antibiotics for presumed GI infection (n=37 [58%] vs. n=0, p<0.05) and proton pump inhibitors for reflux (n=24 [38%] vs. n=3 [10%], p<0.05). The most common GI infections were Giardia lamblia (n=14 [15%]) and Clostridium difficile (n=4 [4%]). Forty-three (45%) patients with GI symptoms underwent colonoscopy, EGD, or both. The most common findings were inflammation, nodular lymphoid hyperplasia, reduced plasma cells, and increased intraepithelial lymphocytes. This is the largest study on CVID patients in a North American setting. The majority of patients experienced GI symptoms. Future studies should study response to treatment for gastrointestinal disease among patients with CVID. Ferring Scholarship Grant Award
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".