A Case of Minimal Change Disease in a Patient with Rheumatoid Arthritis Treated with Certolizumab
Bibliographic record
Abstract
Manifestations of renal disease have been reported to develop after tumor necrosis factor-α (TNF-α) inhibition, and they should be considered as a possible complication as TNF-α inhibitors become more prevalent in the treatment of autoimmune inflammatory diseases. We report a case of minimal change disease (MCD) that developed in a woman receiving the TNF-α inhibitor certolizumab and was resolved with high-dose steroids and discontinuation of TNF-α blockade. Ethics approval was waived by the Mayo Clinic Institutional Review Board; the patient’s written informed consent was obtained. A 49-year-old woman with a background history of rheumatoid arthritis (RA) and Sjögren syndrome presented with a 1-week history of foamy urine, peripheral edema, and 15-kg weight gain. For her RA, she was taking prednisone 5 mg daily and certolizumab 400 mg monthly; the latter had been started 6 months prior to presentation. Physical examination findings demonstrated 2+ pitting edema to the knees … Address correspondence to Dr. S.R. Hwang, Mayo Clinic, 200 1st St. SW, Rochester, Minnesota 55902, USA. E-mail: hwang.steven{at}mayo.edu
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".