Membranous Obstruction of the Inferior Vena Cava Associated with Antiphospholipid Syndrome Presenting with Bilateral Lower Limb Edema
Bibliographic record
Abstract
Membranous obstruction of the inferior vena cava (MOIVC) is an infrequent disorder characterized by an acquired intrinsic obstruction of the hepatic portion of the vena cava. Clinical presentation may vary from an asymptomatic state, to a slowly evolving course of lower extremity swelling, ascites, and progressive cirrhosis. MOIVC may rarely be caused by prothrombotic disorders. Herein, we describe a patient with lupus-erythematosus-associated antiphospholipid syndrome (APS) who presented with subacute venous claudication and bilateral lower limb edema while on oral anticoagulation. Cavography confirmed a diagnosis of MOIVC. The patient successfully underwent percutaneous balloon angioplasty for definitive management and remained symptom-free at 4-year follow-up on long-term anticoagulation therapy. To our knowledge, this is the fourth case description of MOIVC associated with APS successfully treated with balloon angioplasty, but the first with a subacute clinical presentation.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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 | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".