Case report: Focal segmental glomerulosclerosis and nephrotic syndrome following treatment with pamidronate for calcitriol toxicity
Bibliographic record
Abstract
Objective This study aimed to describe a case of glomerulosclerosis resulting in nephrotic syndrome following the administration of pamidronate disodium to treat clinical calcitriol toxicity in a dog. Case summary A 12-week-old intact male Labrador Retriever weighing 11.8 kg presented with lethargy and vomiting for 20 h after ingesting a 100 g tube of topical antipsoriatic cream (3 mcg/g of calcitriol; Vectical Ointment™, Galderma, Lausanne, Switzerland). Severe hypercalcemia was present on the day of the presentation. Hypercalcemia treatments such as saline diuresis, furosemide (Salix®, furosemide, Merck Animal Health, Kenilworth, NJ), and dexamethasone sodium phosphate (Dexamethasone SP, Mylan, Canonsburg, PA) were initiated. The dog was also administered a single dose of pamidronate disodium (Pamidronate disodium, Mylan, Canonsburg, PA) on the day of presentation. Initially, the patient's clinical signs improved, and the hypercalcemia resolved. Exactly 130 h post-pamidronate disodium (Dexamethasone SP, Mylan, Canonsburg, PA) administration, the patient developed biochemical abnormalities and severe edema, consistent with nephrotic syndrome, and was euthanized. Necropsy results revealed evidence of focal segmental glomerulosclerosis (FSGS). Unique information Pamidronate disodium, commonly used for the treatment of hypercalcemia, may have resulted in glomerulosclerosis and nephrotic syndrome in a dog with calcitriol toxicity. This complication should be taken into consideration when monitoring patients treated with pamidronate disodium for hypercalcemia.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 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".