A Diagnostic Dilemma: Adult-Onset Still’s Disease With Secondary Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome?
Bibliographic record
Abstract
Adult-onset Still's disease (AOSD) is a rare autoinflammatory condition. It is a diagnosis of exclusion by ruling out all related infectious, inflammatory, autoimmune, and malignant diseases. We present a case of a 23-year-old Caucasian male who presented with fever, night sweats, joint pain, weight loss, and diarrhea. The initial presentation delayed the diagnosis. Upon further investigation, we formulated the diagnosis of AOSD. In sporadic cases, AOSD with secondary hemophagocytic lymphohistiocytosis (HLH), also known as macrophage activation syndrome (MAS), is a devastating disorder of uncontrolled immune activation characterized by clinical and laboratory evidence of extreme inflammation. In case of suspected secondary complications, timely involvement of a multidisciplinary team and starting of appropriate medications is necessary.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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 teacher head, 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".