Atypical Presentations of Systemic Lupus Erythematosus by Cerebral Venous Thrombosis and Generalized Lymphadenopathy without Antiphospholipid Antibodies: Case Report
Bibliographic record
Abstract
Abstract Introduction: Atypical presentations of systemic lupus erythematosus SLE) with features outside of the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria can make the diagnosis of SLE elusive. Case Presentation: We describe a case of a healthy 31-year old female who presented with syncope preceded by progressive headache, serositis, and generalized lymphadenopathy. CT-head and MR-venogram confirmed a cerebral venous thrombosis (CVT). Subsequent workup revealed high titers of antinuclear (ANA), anti-double stranded DNA (anti-dsDNA), anti-Smith (anti-Sm) antibodies, as well as low complement levels, lymphopenia and neutropenia. Diagnosis of SLE was confirmed by SLICC classification criteria. Antiphospholipid antibodies (APLA) were negative. While in hospital, she sustained a seizure secondary to the CVT. Conclusion: We discuss considerations for atypical SLE presentations by CVT (without APLA syndrome) and generalized lymphadenopathy, and the nuances of SLE diagnosis using existing classification criteria.
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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) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".