Abstract 162: A Case of Fatal Kawasaki - Correlation Between Optical Coherence Tomography and Pathology
Bibliographic record
Abstract
Background: Coronary artery aneurysms (CAA) develop in up to 30% of untreated patients with Kawasaki disease (KD). This may lead to ischemic heart disease and sudden cardiac death, which is extremely rare nowadays. Method: A 3 mo infant presented with severe KD 27 days after onset of fever. He died few days later of multi vessel obstruction and aneurysms. OCT was performed post mortem and correlated with pathology findings. Results: The patient presented with shock, inferolateral ischemia on ECG and high Troponin-i (from 6.45 to 59 μg/L 2 days later). Echocardiography showed severe myocardial dysfunction with diffuse coronary dilation and right CAA. Arterial Doppler demonstrated thrombosis of aneurysmal axillary, subclavian and iliac arteries, which corroborated with clinically ischemic limbs. Withdrawal of support was implemented due to multiorgan failure. OCT images from the proximal RCA, LAD, carotid and pulmonary arteries were obtained post mortem. The circumflex coronary could not be accessed by the OCT catheter, which was occluded on pathology exam. The carotid (figure TOP) and pulmonary arteries were normal on OCT and histology. RCA and LAD (figure BOTTOM) showed aneurysmal dilatation, with marked intimal hyperplasia and preserved media on OCT. Pathology confirmed these findings, with destruction of internal elastic lamina, luminal myofibroblastic proliferation, neovascularization, and attenuation of the media in some sections. Conclusion: This is the first report of pathologic correlation in a severe KD case with OCT imaging at the sub-acute stage, which adequately identified structural wall changes.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".