Letter to the Editor: Microscopic Colitis after Ocrelizumab for Multiple Sclerosis
Bibliographic record
Abstract
To the Editors, Ocrelizumab, an anti-CD 20 humanized monoclonal antibody approved in 2017 for treating multiple sclerosis, has been associated with ensuing colitis in some case reports.1–4 We report the first case of ocrelizumab-induced severe microscopic colitis after 1 dose, requiring hospitalization for supportive management. A 60-year-old female with primary progressive multiple sclerosis was given ocrelizumab 600 mg/IV and 2 months later developed prolonged non-bloody diarrhea, resulting in severe hypokalemia. There was no personal or family history of inflammatory bowel disease. Stool was negative for infection and TTG, serum IgA, TSH, Hgb, and CRP levels were normal. Colonoscopy was normal to the terminal ileum. On histology, the ileum had intact villous architecture with mild intraepithelial lymphocytosis. The colon had increased intraepithelial lymphocytes in the surface epithelium, lamina propria, and crypts. There were plasma cells and mild active inflammation but no alteration of crypt architecture or granuloma. Clinical and histological findings supported a diagnosis of lymphocytic colitis (Figure 1).
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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 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.025 | 0.015 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".