043. SUBGLOTTIC STENOSIS AND ENDOBRONCHIAL DISEASE IN GRANULOMATOSIS WITH POLYANGIITIS
Bibliographic record
Abstract
Background: Damage to the large airways is a devastating complication of granulomatosis with polyangiitis (GPA). This study aimed to characterize patients with subglottic stenosis (SGS) and bronchial disease and test whether dynamic expiratory-phase CT is useful to detect airway damage in patients with GPA. Methods: i) A retrospective analysis of a multi-center cohort of patients with GPA identified demographic and clinical features associated with the presence of SGS or endobronchial involvement; ii) A subset of patients with GPA underwent a dynamic chest CT at a single center, assessed by a central reader blinded to clinical status. Differences were assessed by the chi square test. Results: Data from 962 patients with GPA from 9 centers were used for the initial phase analyses. SGS was identified in 95 (10%) patients. Patients with SGS were more likely to be female, younger, and less likely to have constitutional, cardiovascular, renal, or nervous system involvement. There were no differences in ANCA subtype. Among 95 patients in the cohort with nasal septal perforation and saddle nose deformities, 28 (29%) and 27 (28%), respectively, also had SGS. Endobronchial disease was seen in 59 (6%) patients. Compared to the full cohort, patients with endobronchial involvement were younger, more likely to have ENT involvement, and be C-ANCA/anti-PR3 positive, but less likely to have renal disease. There was no association between endobronchial involvement and sex. Seven of twenty-five patients screened by dynamic chest CT had large-airway pathology. Dynamic CT confirmed SGS in 4 patients with previously identified disease. Tracheobronchomalacia was discovered in 4 patients, including one male patient who was previously thought to have isolated SGS. Abstract 043 Table 1: C-ANCA/anti- PR3 P-ANCA/anti- MPO ANCA-negative Unknown status 63 (67%) 22 (23%) 7 (7%) 3 (3%) 581 (67%) 217 (25%) 43 (5%) 26 (3%) 0.91 0.80 0.33 N/A 50 (85%) 8 (13%) 0 (0%) 1 (2%) 588 (66%) 225 (25%) 54 (6%) 19 (2%) <0.01 0.04 0.04 N/A Conclusion: Both SGS and endobronchial disease are moderately common in GPA. SGS is more commonly seen in female patients with GPA, whereas bronchial involvement is not associated with sex. There should be a low threshold to evaluate airway disease in GPA, especially in younger patients, and those with destructive sinonasal disease. Dynamic expiratory phase chest CT is a potential non-invasive screening test for tracheobronchial disease in GPA. Disclosures: This work was supported by the Vasculitis Clinical Research Consortium and by the intramural NIAMS research program.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".