Non-Anti-Neutrophil Anti-Cytoplasmic Antibodies Associated Methimazole-Induced Nephritis: Case and Review of Literature
Bibliographic record
Abstract
Current anti-thyroid therapy is rarely associated with adverse effects such as vasculitis or nephritis. Historically, vasculitis associated with anti-thyroid therapy is associated with anti-neutrophil anti-cytoplasmic antibodies (ANCA). Here, we report a rare case of ANCA-negative interstitial nephritis secondary to methimazole, resulting in end organ renal failure. A 27-year-old male with a history of Graves’ hyperthyroidism on methimazole anti-thyroid therapy presented to the hospital with shortness of breath and chest pain, complicated by a pericardial effusion and acute kidney injury (AKI) requiring emergent hemodialysis. The diagnosis of drug-induced ANCA-negative vasculitis was based on the temporal relationship between clinically evident vasculitis and treatment with methimazole, after excluding other causes of vasculitis. The lack of ANCA-associated positivity should not deter clinicians from considering stopping the offending agent and pursuing more definitive therapy (radioactive iodine or surgery as appropriate). J Endocrinol Metab. 2018;8(2-3):47-51 doi: https://doi.org/10.14740/jem505w
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".