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Record W2944770895 · doi:10.1210/js.2019-sat-576

SAT-576 Lyme Disease Associated Thyroiditis

2019· article· en· W2944770895 on OpenAlexaff
Navreet Deol, Barna Tugwell

Bibliographic record

VenueJournal of the Endocrine Society · 2019
Typearticle
Languageen
FieldImmunology and Microbiology
TopicVector-borne infectious diseases
Canadian institutionsDalhousie University
Fundersnot available
KeywordsMedicineThyroid peroxidaseLethargyThyroiditisThyroid diseaseInternal medicineThyroidEmergency departmentSore throatLyme diseaseGastroenterologyPediatricsSurgeryImmunology

Abstract

fetched live from OpenAlex

Background: Amino acid sequence homology between human thyroid autoantigens (human thyrotropin receptor, human thyroglobulin, human thyroperoxidase, human sodium iodide symporter) and Borrelia proteins has been reported (1). It has been suggested that Borrelia proteins may be capable of triggering autoimmune thyroid disease in persons with certain HLA-DR alleles (1). Clinical case: A 40-year-old male presented to the Emergency Department (ED) with 3 weeks of worsening night sweats, lethargy, and weakness. He previously had 5 oval shaped spots on his body which had appeared after a recent hiking trip but these had disappeared 1.5 weeks prior to his presentation. He had been experiencing positional chest pain for the 3 days prior to coming to the ED. On admission to the hospital he was found to be febrile and bradycardic with ECG revealing high-grade second-degree type II block. He was started on empiric antibiotics for suspected Lyme disease as he had been hiking in a Lyme endemic area. He also had thyroid indices sent off at the time of presentation which came back consistent with hyperthyroidism. The patient did not endorse neck pain or tenderness, visual symptoms, weight loss, diarrhea, tremors, or palpitations. Anti-TPO antibodies as well as a nuclear medicine thyroid uptake and scan were ordered. His anti-TPO antibodies were positive at 26 IU/mL (n<=6 IU/mL). His uptake at 5 hours of was 0.75%, which is markedly below the lower limit of normal (5%) and as such a thyroid scan could not be performed as there would have been insufficient counts to generate a diagnostic image. His hyperthyroidism was most in keeping with a thyroiditis. As such no thyroid specific treatment was initiated. His Lyme Western Blot IgG eventually returned positive. When he was seen in follow up in outpatient endocrinology clinic, thyroid indices revealed he was hypothyroid, in keeping with the hypothyroid phase often seen in thyroiditis. Conclusion: There are a few studies suggesting borrelia proteins may be capable of triggering autoimmune thyroid disease. This case is supportive of this theory and showcases a presentation of Lyme disease associated thyroiditis. References: (1) Benvenga, S., Guarneri, F. Molecular mimicry and autoimmune thyroid disease. Rev Endocr Metab Disord (2016) 17:485-498.

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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.373
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.006
GPT teacher head0.224
Teacher spread0.217 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2019
Admission routes1
Has abstractyes

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