A case of concurrent Kikuchi-Fujimoto Disease and Neuropsychiatric Lupus in a Patient with Rheumatoid Arthritis and Systemic Lupus Erythematosus Overlap Syndrome
Bibliographic record
Abstract
Kikuchi-Fujimoto disease is a rare, self-limited, histiocytic necrotizing lymphadenitis characterized by cervical lymphadenopathy and fever. An association has been made between the presence of this disease and systemic lupus erythematosus. We describe a unique case of a 31 year old female with a previous diagnosis of rheumatoid arthritis and lupus overlap syndrome who presented with severe headache and subsequently developed altered level of consciousness and seizures. She underwent an extensive assessment which included investigations for an infectious cause, numerous imaging studies, a lymph node biopsy, a bone marrow biopsy, and a brain biopsy resulting in a final diagnosis of concurrent Kikuchi-Fujimoto disease and lupus-associated encephalitis. In these overlap patients, neurological involvement is usually mild. In contrast, our patient presented with severe neuropsychiatric involvement eventually requiring ICU admission. This case highlights the difficulty of diagnosing and managing neuropsychiatric lupus in these complex overlap patients. Early recognition is important to avoid unnecessary and potentially harmful interventions and treatments.
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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 | 0.000 | 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 | 0.000 |
| 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".