Manifestations oto-rhino-laryngologiques au cours des vascularites associées aux ANCA
Bibliographic record
Abstract
L’atteinte de la sphère oto-rhino-laryngologique (ORL) est fréquente et souvent précoce au cours des vascularites associées aux ANCA (VAA). Les principales manifestations de la granulomatose avec polyangéite (GPA) incluent la rhinite croûteuse et hémorragique, la sinusite chronique, l’otite séromuqueuse bilatérale et la sténose sous-glottique. Au cours de la granulomatose éosinophilique avec polyangéite (GEPA), la rhinite et la sinusite chronique avec ou sans polypes dominent le tableau clinique. L’examen clinique et endoscopique par un médecin ORL, fréquemment complété par le scanner, est indispensable à l’évaluation précise des lésions tandis que l’apport des biopsies de muqueuse naso-sinusienne est limité. En plus des traitements systémiques par corticoïdes et immunosuppresseurs, une prise en charge locale est fréquemment nécessaire, du lavage des fosses nasales pour tout patient avec des manifestations rhino-sinusiennes à la réparation chirurgicale des séquelles fonctionnelles et esthétiques au cours de la GPA. L’importance du diagnostic précoce de la vascularite et l’impact des symptômes ORL sur la qualité de vie du patient impliquent une collaboration étroite entre médecin ORL et interniste. Ear, nose and throat (ENT) involvement is common and often an early manifestation in ANCA-associated vasculitides (AAV). The main ENT symptoms of granulomatosis with polyangiitis (GPA) include nasal crusting, epistaxis, chronic rhinosinusitis, bilateral serous otitis media and subglottic stenosis. In eosinophilic granulomatosis with polyangiitis (EGPA), rhinitis and chronic sinusitis with or without polyps are predominant clinical features. Clinical and endoscopic examination by an ENT specialist, often complemented by CT scan, is essential for accurately assessing lesions while the contribution of nasal mucosal biopsies is limited. In addition to systemic treatments with corticosteroids and immunosuppressants, local management is often required, ranging from nasal irrigation for all patients with rhinosinusitis symptoms to surgical repair of functional and aesthetic sequelae in the course of GPA. The importance of early diagnosis of vasculitis and the impact of ENT symptoms on the patient's quality of life require close collaboration between ENT specialist and internist.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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.
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".