Teenage heartache: A 14-year-old with pleuritic chest pain
Bibliographic record
Abstract
A 14-year-old transgender male presented with 1 month of worsening intermittent pleuritic chest pain, 2–3 weeks after an upper respiratory infection. A review of systems revealed mild fatigue, low appetite and mild frontal headache without red flags. Examination revealed left-sided ptosis, persistent tachycardia (max 125 bpm), pulsus paradoxus, distant heart sounds and decreased air entry at lung bases. No pericardial rub. C-reactive protein (CRP) 201.9 mg/L (high). Blood count showed microcytic anaemia (haemoglobin 77 g/L). Serum electrolytes, creatinine, urinalysis, liver enzymes and coagulation profile were normal. Troponin 4 ng/L (high). Echocardiogram showed significant pericardial effusion with right atrial collapse. Chest x-ray revealed small pleural effusions (Figure 1). Urgent pericardiocentesis was performed, and Naproxen was started for presumed viral pericarditis. ... Rheumatology was consulted after limited improvement on Naproxen and a negative infectious workup (including tuberculosis). Ophthalmic exam showed inflammatory dacryoadenitis. CT orbit revealed a left lacrimal mass (Figure 2). Biopsy showed scar tissue with few plasma cells, no granulomas or eosinophils, and negative IgG4 staining. Chest CT showed non-specific ground-glass opacities and mild diffuse interlobular septal thickening. Pulmonary function test (PFT) showed a mixed obstructive-restrictive pattern. Serum ANA and IgG4 normal. Myeloperoxidase (MPO)-ANCA was strongly positive >134 U/L, informing diagnosis and management.
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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 | 0.000 |
| 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 | 0.000 |
| 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".