Spontaneous Anterior Neck Hematoma Associated With Rivaroxaban Leading to Primary Hyperparathyroidism and Hypercalcemia
Bibliographic record
Abstract
New anticoagulation agents are now widely used for many indications. Post-marketing surveillance is intended to discover rare medication events that did not occur in clinical trials. The literature cites few reported cases of spontaneous neck hemorrhage while on anticoagulation. We report a case of an 86-year-old female with chronic atrial fibrillation who presented with spontaneous neck hematoma in the area of the parathyroid glands resulting in hyperparathyroidism and hypercalcemia while taking rivaroxaban. The hematoma spanned the anterior aspects of the neck and was confirmed via CT. The patient’s anticoagulation therapy was discontinued and required intubation for airway protection. The parathyroid hormone (PTH) peaked to 176 mg/dL (upper limit of normal 65 pg/mL) followed by close to normalization of PTH and corrected calcium after appropriate treatment and stabilization of the hematoma, which did not require surgical evacuation. J Med Cases. 2015;6(2):87-90 doi: https://doi.org/10.14740/jmc1825w
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| 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".