Myelofibrosis and Antiphospholipid Syndrome Presenting With Adrenal Insufficiency Due to Bilateral Adrenal Hemorrhage: A Case Series
Bibliographic record
Abstract
Adrenal hemorrhage is rare but appears to occur more frequently in patients with underlying hematological conditions. We report two recent patients with underlying hematological disorders who presented with adrenal insufficiency due to bilateral adrenal hemorrhage. The first case is a 59-year-old woman known to have myelofibrosis. This patient was being treated with warfarin for left leg deep vein thrombosis which developed after splenectomy. She was admitted to hospital with vomiting and abdominal pain. The second case is an 84-year-old male patient with antiphospholipid syndrome and diabetes mellitus who was treated with warfarin and insulin. He was admitted with sudden onset of nausea, hypotension and recurrent hypoglycemia despite cessation of insulin therapy. In both cases, bilateral enlarged adrenal glands consistent with hemorrhage were detected resulting in adrenal insufficiency. It is important that Hematologists and Endocrinologists alike should recognise symptoms of adrenal insufficiency in patients with hematological disorders, particularly those being treated with antiplatelet medications or anticoagulants. J Endocrinol Metab. 2011;1(3):142-145 doi: https://doi.org/10.4021/jem31w
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 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".