SJOGREN-LYMPH is a dependency-free executable clinical heuristic for primary Sjogren disease that converts persistent parotid swelling, low C4, cryoglobulinemia, palpable purpura, cytopenias, lymphadenopathy, gland masses, monoclonal gammopathy, beta-2 microglobulin elevation, and germinal-center histology into a transparent 0-100 lymphoma concern score. The skill returns a concern band and escalation recommendation to help decide when to pursue imaging, hematology review, or biopsy-oriented workup.
**Background:** Patients with positive antinuclear antibodies (ANA) who do not fulfill classification criteria for a specific connective tissue disease (CTD) are often labeled as having "undifferentiated" autoimmune disease — a diagnostic category that functions as a clinical waiting room. ANA patterns classified by the International Consensus on ANA Patterns (ICAP) contain prognostic information that remains systematically underutilized.
Serologically active clinically quiescent (SACQ) systemic lupus erythematosus is a practical bedside problem because abnormal anti-dsDNA and complement can persist without overt symptoms. SACQ-LUPUS is an executable transparent skill that separates stable serologic activity from smoldering flare risk and stops labeling the case SACQ once urinary or extra-renal flare signals appear.
ADA-Predictor is a transparent clinical support tool for anti-drug antibody risk in biologic-treated autoimmune disease. It estimates immunogenicity risk using biologic class, methotrexate co-therapy, HLA-DQA1*05 status, prior biologic failure, inflammatory burden, smoking, disease duration, and BMI, then converts the result into a risk tier and therapeutic monitoring suggestion.
Systemic corticosteroids can precipitate insomnia, mood elevation, mania, depression, psychosis, or delirium. We describe STEROID-PSYCH, a transparent heuristic score that integrates steroid dose, pulse exposure, treatment duration, psychiatric history, sleep loss, delirium vulnerability, CNS inflammation, age, and acute medical instability to make psychiatric risk explicit before or during steroid therapy.
Wearable devices can capture physiology continuously, but autoimmune care still lacks a transparent bedside method for deciding when a cluster of changes in heart rate, heart-rate variability, oxygen saturation, and activity should count as a clinically meaningful flare signal rather than noise. We present VITALS-WATCH, a dependency-light Python skill that combines baseline-referenced wearable vital-sign summaries with Bayesian online change-point detection and a simple multi-channel flare score.
HRCT-ILD is a transparent, dependency-free clinical skill that scores semi-quantitative HRCT features and estimates UIP, NSIP, and organizing pneumonia pattern probabilities while separately checking ATS/ERS/JRS/ALAT UIP criteria. The tool is designed for adult ILD triage and multidisciplinary discussion, not stand-alone diagnosis or image segmentation.
ANEMIA-IMMUNE stratifies anemia in autoimmune disease by combining hemoglobin severity, MCV, ferritin, transferrin saturation, CRP, reticulocytes, kidney function, bleeding signals, hemolysis signals, and myelosuppressive drugs into a transparent 0-100 concern score and phenotype label. The implementation is executable Python and is intended to support differential diagnosis of iron deficiency, inflammation/CKD-pattern anemia, mixed anemia, and probable marrow-suppression/hemolysis context.
LEF-WASH is a transparent clinical heuristic for reproductive-safety triage when leflunomide is active, recently stopped, or being cleared before conception in rheumatic and autoimmune disease. The bedside problem is not whether the drug was merely discontinued, but whether cholestyramine washout occurred, whether teriflunomide clearance below 0.
ANIFRO-HZ is an executable, transparent clinical decision-support skill for stratifying herpes zoster concern in systemic lupus erythematosus during or soon after anifrolumab exposure. The bedside problem is not only knowing that zoster risk exists, but recognizing when glucocorticoids, lymphopenia, nephritis-level co-immunosuppression, absent recombinant zoster vaccination, and early symptom patterns create a treatment context that should alter monitoring or escalation.
## Abstract
Anticoagulation in antiphospholipid syndrome (APS) remains clinically contentious because the convenience of direct oral anticoagulants (DOACs) is not matched by uniform safety across APS phenotypes. The central bedside problem is not whether DOACs are ever usable, but whether a given patient sits in a high-risk phenotype where DOAC exposure is especially unfavorable.
Denosumab discontinuation creates a distinctive clinical hazard: vertebral-fracture risk can rebound rapidly when treatment is delayed or stopped without sequential antiresorptive therapy. This problem is especially relevant in rheumatology and glucocorticoid-treated osteoporosis, where missed injections may go unnoticed until new back pain or clustered vertebral fractures emerge.
HCQ-QT is an executable Python skill for transparent QT-prolongation risk-context stratification before or during hydroxychloroquine therapy in rheumatic and autoimmune disease. It weights baseline QTc, sex-age context, kidney function, potassium and magnesium status, structural and arrhythmic cardiac history, bradycardia, concomitant QT-prolonging drugs, hydroxychloroquine dose intensity, and syncope or palpitations into a 0-100 concern score.
PRES-LUPUS is an executable Python skill for transparent bedside risk-context stratification of posterior reversible encephalopathy syndrome in systemic lupus erythematosus. It addresses a real clinical recognition problem: when acute neurologic symptoms during lupus nephritis, severe hypertension, and high-intensity immunosuppression should trigger urgent PRES exclusion rather than delayed attribution to flare alone.
SRC-SHIELD is an executable Python skill for transparent scleroderma renal crisis risk-context stratification in systemic sclerosis. It weights diffuse cutaneous phenotype, early disease duration, anti-RNA polymerase III positivity, glucocorticoid exposure, new hypertension, creatinine rise, proteinuria, and microangiopathic features into a 0-100 concern score.
Occult Strongyloides stercoralis infection is an under-recognized safety problem in rheumatology and autoimmune care because clinically silent infection may accelerate into hyperinfection after glucocorticoids or other potent immunosuppression. STRONGY-GUARD is an executable Python skill that converts this bedside problem into a transparent 0-100 risk-context score using endemic exposure, eosinophilia, positive serology, positive stool/larvae, glucocorticoid intensity and duration, pulse methylprednisolone, rituximab/cyclophosphamide exposure, HTLV-1, compatible symptoms, gram-negative sepsis, current immunosuppression, and recent ivermectin treatment.
Vaccination planning around rituximab is a recurring clinical problem in rheumatic and autoimmune disease because clinicians must balance infection-prevention urgency against expected vaccine blunting after B-cell depletion. RTX-VAX is an executable Python skill for transparent readiness stratification before non-live vaccination.
Adult-onset Still disease activity is often described narratively despite major variability in systemic burden and MAS risk. AOSD-ACTIVITY is an executable Python skill that computes a transparent 12-item systemic feature score rooted in published Still disease literature, then layers practical MAS warning heuristics using ferritin, fibrinogen, platelet count, transaminases, and triglycerides when available.
NSAID-associated acute kidney injury remains a common and preventable clinical problem, especially in older adults, chronic kidney disease, heart failure, cirrhosis, volume depletion, and the classic ACE inhibitor or angiotensin receptor blocker plus diuretic setting. We present NSAID-AKI, an executable Python skill for transparent NSAID-associated AKI risk-context stratification.
Lower gastrointestinal perforation during IL-6 blockade is uncommon but clinically serious, and tocilizumab has repeatedly been associated with higher rates of diverticulitis-related lower-GI perforation than several alternative biologic strategies in rheumatoid arthritis cohorts. We present TCZ-PERF, an executable Python skill for transparent risk stratification before or during tocilizumab use in rheumatic and autoimmune disease.