Acute Myocarditis in Patients with Antineutrophil Cytoplasmic Antibody–positive Microscopic Polyangiitis and Receiving Rituximab Therapy
Bibliographic record
Abstract
The presence of cardiac insufficiency is recognized as a poor prognostic factor in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV)1, and heart failure is an identified mortality risk factor for eosinophilic granulomatosis with polyangiitis (EGPA)2. Microscopic polyangiitis (MPA) has lower frequencies of myocardial involvement with rarely reported acute myocarditis presentation3. Rituximab (RTX) is a first-line induction therapy licensed for severe MPA with reduced ANCA titers and clinical remission4. In this study, we reviewed hospitalized patients with MPA who were receiving RTX therapy for acute myocarditis-related heart failure. A retrospective study was carried out at the National Cheng Kung University Hospital from January 2014 to December 2018. Hospitalized patients fulfilling the 2012 Revised Chapel Hill Consensus Conference MPA definition5 were analyzed under the permission of the institutional review board (approval no. B-ER-105-108). Acute myocarditis was defined as (1) symptoms such as fever, dyspnea, orthopnea, chest pain, and palpitation; (2) raised cardiac biomarker levels; and (3) new/worsening echocardiograph or cardiac magnetic resonance imaging (cMRI) changes including wall motion abnormalities and impaired left ventricular ejection fraction (LVEF) … Address correspondence to Dr. C.R. Wang, Section of Rheumatology, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan 70428, Taiwan. E-mail: wangcr{at}mail.ncku.edu.tw
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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".