Findings in Chest Images of Children With Systemic Lupus Erythematosus
Bibliographic record
Abstract
Abstract Systemic lupus erythematosus (SLE) is a chronic systemic disease associated with high morbidity and mortality that can affect the lungs with varying degrees of severity. Therefore, it is crucial to understand the imaging patterns that can be found in chest CT scans of children with SLE. Our objective is to describe the findings in chest CT of patients diagnosed with SLE who were treated at HOMI from 2022 to 2024.An observational, descriptive, cross-sectional study was conducted. All patients aged 0 to 18 years diagnosed with SLE and treated at HOMI (a fourth-level hospital in Bogotá, Colombia) between 2022 and 2024, who underwent a chest CT, were screened. Qualitative variables were analyzed using frequency and percentage, and quantitative variables were analyzed using medians and interquartile ranges due to their non-normal distribution.Among two hundred and twenty patients screened, 25 patients with pulmonary involvement were included. The median was 15 years and 96% were female. Forty percent required hospitalization and management in intermediate care or the ICU. Rhinoenterovirus was isolated in 2 out of 6 patients in whom a filmarray was performed. A chest X-ray was conducted in 87.5% of the children. Atelectasis were reported in 48% of these cases, and ground-glass opacities were seen in 28%. Additionally, 20% had pleural effusion.Atelectasis were evident in 60% of chest CT scans. Pleural effusions and ground-glass opacities were observed in 32% and 28%, respectively. Consolidation, micronodules, and intrapulmonary lymph nodes were found 16% of the images. Granulomas and alveolar hemorrhages were evident in 8%. Only one patient had a normal image. Twenty-four patients had a complete blood count, 48% exhibited anemia, 32% had thrombocytopenia, and 48% had lymphopenia. Children with lymphopenia showed less consolidations compared to those with normal leukocytes (4 vs. 0 patients), with statistical significance (p = 0.047).Our cohort demonstrates that pediatric patients with SLE and pulmonary compromise can present with a wide variety of imaging findings. However, the significance of these findings are not well defined in the literature. For instance, atelectasis, although unspecific, was the most common finding in hospitalized patients, indicating central airway compromise. Pleural effusions were also frequently observed given the well-known pathophysiology of SLE. This study emphasizes the need for further evaluation of the significance and prognostic implications of imaging findings, and the prompt evaluation by a pulmonologist in children with SLE presenting with respiratory symptoms.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".