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Record W4412075413 · doi:10.1136/bcr-2025-267448

From immunotherapy to autoimmunity: reactive arthritis following intravesical BCG

2025· article· en· W4412075413 on OpenAlexaff
Saad Alqasem, Sophie Wojcik, Jacques Corcos

Bibliographic record

VenueBMJ Case Reports · 2025
Typearticle
Languageen
FieldMedicine
TopicBladder and Urothelial Cancer Treatments
Canadian institutionsJewish General HospitalMcGill University
Fundersnot available
KeywordsMedicineOligoarthritisImmunotherapyMalignancyReactive arthritisArthritisDiscontinuationAutoimmunityBladder cancerImmunologyCancerDermatologyInternal medicinePolyarthritisImmune system

Abstract

fetched live from OpenAlex

Reactive arthritis (ReA) is recognised as a sterile inflammatory arthritis triggered by infections or other antigens, including intravesical BCG used to treat non-muscle-invasive bladder cancer. Although BCG immunotherapy is highly effective, its side effects can extend beyond the genitourinary tract. We present a woman in her 60s with high-grade Ta urothelial cell carcinoma (UCC) and carcinoma in situ (CIS) who developed ReA 1 week following BCG instillation. She experienced fevers, blurred vision, mild conjunctivitis and oligoarthritis predominantly affecting her knees. Infection was ruled out by negative cultures, while elevated inflammatory markers pointed to an autoimmune aetiology. Prompt discontinuation of BCG and corticosteroid therapy led to significant clinical improvement. This case underscores the importance of recognising ReA as a potential post-BCG complication requiring multidisciplinary management. It highlights the need for intervention and follow-up.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Direct model labels (unvalidated)

Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.

Model armCategoriesStudy designConfidence
gemmano category
Domain: not available · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Case reportlow
gptno category
Domain: not available · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Case reporthigh
models agreeAgreement compares identical category sets and study designs across arms.

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.007
Threshold uncertainty score0.012

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.001
Science and technology studies0.0020.002
Scholarly communication0.0020.002
Open science0.0010.001
Research integrity0.0070.005
Insufficient payload (model declined to judge)0.0020.001

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.

Opus teacher head0.017
GPT teacher head0.338
Teacher spread0.321 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Labeled directly by 2 models reading the full record.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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