Bibliographic record
Abstract
Purpose: A 51-year old woman presented with a two-month history of watery diarrhea and 20-pound weight loss. Stools occurred 8-10 times a day and were without blood or features of steatorrhea. She had a part history of type I diabetes and was on insulin. Physical examination was unremarkable. Initial investigations showed WBC 13.3 (ANC 11.2), Hb of 143 g/dL, platelet count of 331. Albumin was 19 g/L (normal 33-53 g/L) and C-reactive protein was elevated at 15.4 mg/L. TTG was 0 with a normal IgA level. Stool studies were negative for C. difficile toxin and bacterial pathogens. CT scan of the abdomen and pelvis demonstrated a fluid-filled colon but without colonic wall thickening and normal small intestine. Gastroscopy revealed numerous, white, plaque-like pseudomembranes throughout the stomach and first portion of the duodenum. On colonoscopy, pseudomembranes were seen in the right colon, rectosigmoid and also in the terminal ileum. Biopsies from all sites showed thickened subepithelial collagen and lymphocytic inflammation. A diagnosis of collagenous gastritis, enteritis and colitis was made. The patient was treated with Entocort 9 mg daily and her symptoms improved within days. Follow-up gastroscopy after 12 weeks of therapy showed normal mucosa. Gastric and duodenal biopsies showed resolution of the collagen band but residual lymphocytic inflammation. The albumin and C-reactive protein normalized to 40 g/L and 1.8 mg/L, respectively. Discussion: Collagenous gastritis is a rare disorder, first described in 1989. It is usually associated with collagenous colitis and sometimes, collagenous enteritis. It is associated with type I diabetes as well as celiac disease. Response to steroid therapy is typical although relapse is common. This case was unique in that the patient had endoscopically visible pseudomembranes, which has not been previously described in collagenous gastritis. Most cases of pseudomembranous gastritis have been related to infection, such as aspergillosis, in an immune-compromised host. This case indicates that collagenous gastritis should be in the differential of pseudomembranous gastritis.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".