A Case of Scleromyxedema Development Following Intravesical Bacillus Calmette-Guérin Administration
Bibliographic record
Abstract
To the Editor: We read with great interest the case report written by Boleto et al1 entitled, “Rapidly Progressive Systemic Sclerosis-associated Interstitial Lung Disease After Intravesical Bacillus Calmette-Guérin Therapy for Early-stage Bladder Cancer”. In this article, the authors speculated on a possible association between intravesical bacillus Calmette-Guérin (BCG) administration and progression in systemic sclerosis (SSc)-associated interstitial lung disease. Our aim is to present a case that will support the authors’ theory indirectly, as well as to briefly discuss the possible pathogenesis in the context of intravesical BCG-mediated SSc, thereby increasing the necessary awareness of this issue among physicians. A 48-year-old male with a previous history of hypertension and bladder cancer was admitted due to the development of progressive widespread skin tightness and decreased movement in all extremities. The patient’s medical history revealed that 6 weekly intravesical BCG instillations following transurethral resection (TUR) was commenced in 2017. After 3 years in remission, a second TUR was performed, together with a 6-week BCG treatment due to tumor recurrence. Two weeks after the last BCG administration, rapid stiffness and inability to move … Address correspondence to Dr. R. Yildirim, Department of Rheumatology, School of Medicine, Eskişehir Osmangazi University Eskişehir, 26480, Turkey. Email: celeng18{at}gmail.com.
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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 | 0.001 | 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 | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 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".