Henoch–Schönlein purpura induced by sitagliptin: A case report
Bibliographic record
Abstract
Dipeptidyl peptidase-4 inhibitors are oral antihyperglycemic medications often used as adjuncts to other antidiabetic agents to treat type 2 diabetes mellitus. Henoch-Schönlein purpura, also known as ImmunoglobulinA (IgA) vasculitis, is a form of IgA-mediated leukocytoclastic vasculitis, which is rarely reported in adults. Herein, we report the case of a 52-year-old male with type 2 diabetes mellitus who presented with petechiae, ecchymoses, and palpable purpura below the knees bilaterally after starting sitagliptin, a dipeptidyl peptidase-4 inhibitor. A punch biopsy for direct immunofluorescence showed granular Immunoglobulin A, M, and complement 3 in vessel walls, suggestive of Henoch-Schönlein purpura. Sitagliptin was discontinued, and the patient was treated with celecoxib, colchicine, and cefadroxil for wound infection. Three months after initial presentation, brown hyperpigmentation was appreciated, suggestive of post-inflammatory changes and resolution of the lesions. However, urinalysis revealed new 0.3 g/L protein. Overall, this case highlights a new potential association of dipeptidyl peptidase-4 inhibitors with Henoch-Schönlein purpura, which may have systemic consequences.
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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) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 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".