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 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 | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.012 | 0.007 |
| 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".