BULLOUS LUPUS, AN UNCOMMON CAUSE OF ATYPICAL ESOPHAGITIS: A CASE REPORT
Bibliographic record
Abstract
PV295 / #313 Case Report Poster Topic: AS22 - SLE Heterogeneity Introduction Systemic lupus is a condition that continually reveals its complexities, both systemically and dermatologicaly. Bullous lupus which accounts for less than 5%, poses a true diagnostic and therapeutic challenge. We report a case of bullous lupus with severe esophageal involvement. Case Presentation With Investigation Observation: A 42 years old woman with no significant medical history apart from an esophagitis resistant to treatment for 2 years, presented with dysphagia. An upper digestive endoscopy revealed multiple esophageal strictures with fragile mucous membrane which bleed on contact with the endoscope.This esophagitis was resistant to proton pump inhibitor treatment. Histological examination of the esophageal biopsies suggested a fleshy polyp without evidence of eosinophilic infiltration or tuberculoid granuloma. The immunological assessment (ANA,ANCA,anti-CCP, rheumatoid factor, antiphospholipid antibodies and celia serology) was negative. Additionnally, the patient exhibited fragile skin, oral ulcers and some vesicular and crusty lesions in sun exposed areas. Histological study and direct immunofluorescence of the skin biopsy found an epidermolysis with antiC1q of IgM and IgG type;and C3-C4 complement fraction deposits; which argues for the diagnosis of bullous lupus with lupus esophageal involvement. The patient was placed on immunosuppressive treatment (corticosteroids and azathioprine), with favorable clinical outcomes. Literature Review [1.] Sprow G. Int J Womens Dermatol 2022;8(3);e034. [2.] Smith KN. Dermatol Online J 2023;29(6). Discussion Bullous lupus is an extremely rare entity,and its esophageal involvement complicates diagnosis.Although its therapeutic management may seem straightforward,it remains a significant challenge for practitioners.
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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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 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".