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 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 | 0.001 | 0.005 |
| 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 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.004 |
| 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".