Life-Threatening Haemorrhagic Enterocolitis: A Rare Complication of Chemotherapy With Cyclophosphamide
Bibliographic record
Abstract
Cyclophosphamide (CPA) is a commonly used alkylating agent with its use extending from chemotherapy to immunosuppression. Herein, we present a case of a 61-year-old lady diagnosed with Sjögren's syndrome one year ago, who recently started on CPA therapy and presented to ICU with the sudden onset of bloody diarrhoea and shock, requiring fluid resuscitation and vasopressor support. An extensive evaluation, including stool routine analysis, cultures, stool BioFire® FilmArray® (gastrointestinal panel) (BioFire Diagnostics, LLC, Salt Lake City, USA), contrast-enhanced CT (CECT) of the abdomen, colonoscopy, and biopsy, ruled out infectious, inflammatory, ischemic, and malignant causes. After discontinuation of CPA and supportive therapy, her clinical condition improved, and she was discharged. Haemorrhagic cystitis, myelosuppression, gonadal toxicity and interstitial pneumonia are well-known side effects of CPA. Haemorrhagic enterocolitis is a rare adverse effect of CPA therapy. Through this case report, we aim to highlight that haemorrhagic enterocolitis can be a potentially life-threatening adverse effect of CPA, a drug widely used in rheumatological and oncological conditions. Increased awareness among treating physicians can help in early suspicion and appropriate management, including prompt discontinuation of the drug and consideration of alternative treatment options.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".