Bloodless Glomeruli: A Case Report on Scleroderma Renal Crisis
Bibliographic record
Abstract
Scleroderma renal crisis (SRC) is a main complication of systemic sclerosis affecting approximately one-fifth of the patient population with the disease. We present a case of a 38-year-old African American female who initially presented with findings suggestive of thrombotic thrombocytopenic purpura; however, the clinical manifestations, laboratory findings and renal biopsy confirmed the diagnosis of SRC. The case is worth reporting in medical literature because of its unique presentation and to note the findings of the kidney biopsy. SRC can present initially as thrombotic thrombocytopenic purpura; therefore, clinicians need to be more aware of this entity and it should be considered in the differential diagnosis of microangiopathic hemolytic anemia. This case also illustrates that the classic “onion skin appearance” on kidney biopsy in SRC is not always present and that patients can have “bloodless” glomeruli. J Med Cases. 2018;9(7):229-232 doi: https://doi.org/10.14740/jmc3018w
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 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".