Discordance between biochemical and histological severity in persistent immune checkpoint inhibitor induced liver injury
Bibliographic record
Abstract
We report a case of a man in his early 70s referred for Grade 2 immune checkpoint inhibitor induced liver injury (ChILI) post nivolumab and ipilimumab for metastatic melanoma. Despite treatment with immunosuppression, the liver enzymes improved but failed to normalise completely. Liver biopsy performed 6 months after diagnosis identified a severe hepatitis with interface and perivenular necroinflammatory activity. Mycophenolate was up-titrated to 1 g twice daily and prednisone 40 mg daily was commenced. Once liver enzymes normalised immunosuppression was then gradually withdrawn, with no recurrent elevation of the liver enzymes. This case demonstrates that there can be an incongruency between liver enzymes an histopathology in ChILI. As in our patient, this can have significant implications in managemen. Furthermore, this case is unique as there are no other reported cases in the literature of chronic ChILI.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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 | 0.000 |
| 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".