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Record W4396996568 · doi:10.1681/asn.20203110s1838d

IgA Nephropathy in a Patient with Beta-Thalassemia Minor: A Case Report

2020· article· en· W4396996568 on OpenAlexaff
Andric Pérez-Ortíz, Carmen Ávila-Casado, Gregorio T. Obrador

Bibliographic record

VenueJournal of the American Society of Nephrology · 2020
Typearticle
Languageen
FieldMedicine
TopicBlood groups and transfusion
Canadian institutionsUniversity Health Network
Fundersnot available
KeywordsBeta thalassemiaMedicineNephropathyThalassemiaInternal medicineBETA (programming language)GastroenterologyUrologyEndocrinologyDiabetes mellitusComputer science

Abstract

fetched live from OpenAlex

Introduction: IgA nephropathy (IgAN) is the most prevalent type of primary glomerulonephritis worldwide. There are few reports on IgAN development in thalassemia, especially among beta-thalassemia trait (minor) carriers. Case Description: A 52-year-old male Mexican patient was evaluated for hypertension, hematuria, proteinuria, and rising serum creatinine levels. His history included an ischemic cerebrovascular accident and beta-thalassemia minor (trait). He was treated initially, by another provider, with hydrochlorothiazide/irbesartan and carvedilol for hypertensive nephropathy. Despite treatment, he continued with rising creatinine levels. Then, he was switched to irbesartan only. During this period, the patient developed metabolic acidosis treated with NaHCO3. When referred to our care, we began our approach by completing biochemical and immunodiagnostics assessments (IF), ultrasound imaging (USG), and pathology for glomerulonephritis. On biopsy, we observed IgA nephropathy with advanced nodular glomerulosclerosis and grade II interstitial fibrosis. On IF, IgA, C3, lambda, and kappa chains (mild) were positive. IgG, IgM, C1q were negative. On USG, we documented renal replacement lipomatosis. The patient had microcytic hypochromic anemia, but GBM, C3, C4, ANA antibodies were negative. We managed successfully with irbesartan, amlodipine, NaHCO3 then furosemide. Discussion: To our knowledge, there are only three additional cases of IgA nephropathy among beta-thalassemia minor. All, including ours, shared as chief complaint rising serum creatinine, hypertension, and persistent microscopic hematuria. However, one report noted bilateral sensorineural hearing loss and prior psychosis under treatment, which may be a syndromic disease presentation. A common feature also is negative antinuclear, anti-DNA, anti-neutrophil cytoplasmic, anti-glomerular basement membrane antibody, HBV, HIV, serum complements antibodies. Significantly, at the time of biopsy, all cases had fibrosis in various degrees ranging from partial to global sclerosis with fibrous crescents. Notably, prior cases occurred in Asian ethnicities, were IgAN is prevalent; our case is the first Hispanic affected patient.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.480
Threshold uncertainty score0.310

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.014
GPT teacher head0.249
Teacher spread0.235 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2020
Admission routes1
Has abstractyes

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