Impact of immunosuppressive states on Graves’ orbitopathy: Case report and literature review
Bibliographic record
Abstract
Our case report highlights the potential atypical presentation and course of Graves’ orbitopathy (GO) in immunosuppressed patients, focusing on a patient who had undergone a liver transplant. The patient presented with esthetic periocular changes but was found to have findings including binocular diplopia and eyelid retraction and was suspected of having GO. Initial examination revealed symptoms such as periocular fat proliferation, diplopia, and worsening dry eyes. She was on tacrolimus for immunosuppression. Further evaluations and imaging confirmed GO, and the patient’s immunosuppressed state due to her liver transplant raised concerns about standard treatments. A multidisciplinary approach was required, and eventually, left orbital oculoplastic decompression surgery was performed, resolving symptoms and improving vision and comfort. This case underscores the complexities of managing GO in immunosuppressed patients and aligns with existing literature on the subject.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 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 | 0.001 |
| 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".