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T1 Age 2 13 23 year old T2 Personal_background 14 19 white T3 Sex 20 24 male T4 History 32 65 4 year history of Crohn's disease T5 Disease_disorder 50 65 Crohn's disease E1 Disease_disorder:T5 T6 Duration 32 38 4 year E2 Duration:T6 T7 Sign_symptom 109 116 malaise E3 Sign_symptom:T7 #1 AnnotatorNotes E3 Note that this isn't clinical history as it's the beginning of the story here. T8 Sign_symptom 118 123 fever E4 Sign_symptom:T8 T9 Sign_symptom 135 139 pain E5 Sign_symptom:T9 T10 Biological_structure 125 134 abdominal R1 MODIFY Arg1:T10 Arg2:E5 T11 Sign_symptom 141 149 vomiting E6 Sign_symptom:T11 T12 Biological_structure 154 160 stomal #2 AnnotatorNotes T12 The patient presumably has a colostomy or ileostomy T13 Sign_symptom 161 170 diarrhoea E7 Sign_symptom:T13 R2 MODIFY Arg1:T12 Arg2:E7 T14 Duration 90 97 two day E8 Duration:T14 R3 MODIFY Arg1:E2 Arg2:E1 R4 MODIFY Arg1:E8 Arg2:E3 R5 MODIFY Arg1:E8 Arg2:E4 R6 MODIFY Arg1:E8 Arg2:E5 R7 MODIFY Arg1:E8 Arg2:E6 R8 MODIFY Arg1:E8 Arg2:E7 T15 Sign_symptom 195 200 pains E9 Sign_symptom:T15 T16 Biological_structure 189 194 joint R9 MODIFY Arg1:T16 Arg2:E9 T17 Biological_structure 215 224 shoulders T18 Biological_structure 226 232 elbows T19 Biological_structure 234 240 wrists T20 Biological_structure 242 262 metacarpophalangeals T21 Biological_structure 264 269 knees T22 Biological_structure 274 280 ankles R10 MODIFY Arg1:T17 Arg2:E9 R11 MODIFY Arg1:T18 Arg2:E9 R12 MODIFY Arg1:T19 Arg2:E9 R13 MODIFY Arg1:T20 Arg2:E9 R14 MODIFY Arg1:T21 Arg2:E9 R15 MODIFY Arg1:T22 Arg2:E9 T23 Sign_symptom 299 303 rash E10 Sign_symptom:T23 T24 Biological_structure 311 317 elbows R16 MODIFY Arg1:T24 Arg2:E10 T25 Biological_structure 319 325 ankles T26 Biological_structure 330 334 feet R17 MODIFY Arg1:T25 Arg2:E10 R18 MODIFY Arg1:T26 Arg2:E10 T27 Sign_symptom 364 371 macules E11 Sign_symptom:T27 T28 Detailed_description 351 363 erythematous R19 MODIFY Arg1:T28 Arg2:E11 T29 Sign_symptom 403 410 lesions E12 Sign_symptom:T29 T30 Sign_symptom 423 431 crusting E13 Sign_symptom:T30 T31 Detailed_description 387 402 vesico-pustular R20 MODIFY Arg1:T31 Arg2:E12 T32 History 443 472 no history of sexual exposure T33 Sign_symptom 493 502 infection E14 Sign_symptom:T33 A1 POLARITY E14 NEG T34 Medication 514 535 no regular medication E15 Medication:T34 A2 POLARITY E15 NEG T35 Medication 558 565 Pentasa E16 Medication:T35 #3 AnnotatorNotes E16 Nonsteroidal anti-Inflammatory drug T36 Date 566 582 4 months earlier E17 Date:T36 T37 Date 584 601 One month earlier E18 Date:T37 T38 Therapeutic_procedure 621 631 laparotomy E19 Therapeutic_procedure:T38 T39 Sign_symptom 667 674 fistula E20 Sign_symptom:T39 T40 Detailed_description 652 666 ileo-cutaneous T41 Detailed_description 644 651 complex R21 MODIFY Arg1:T40 Arg2:E20 R22 MODIFY Arg1:T41 Arg2:E20 T42 Detailed_description 680 692 blind tracts R23 MODIFY Arg1:T42 Arg2:E20 T43 Date 698 715 two weeks earlier E21 Date:T43 T44 Therapeutic_procedure 732 741 ileostomy E22 Therapeutic_procedure:T44 T45 Detailed_description 718 731 defunctioning R24 MODIFY Arg1:T45 Arg2:E22 T46 Sign_symptom 791 795 pain E23 Sign_symptom:T46 T47 Biological_structure 781 790 abdominal R25 MODIFY Arg1:T47 Arg2:E23 T48 Detailed_description 770 780 persistent R26 MODIFY Arg1:T48 Arg2:E23 T50 Biological_structure 801 810 cutaneous T51 Duration 819 846 had been present for a year E24 Duration:T51 T52 Duration 923 951 of at least 2 years duration E25 Duration:T52 T53 Sign_symptom 915 922 fistula E26 Sign_symptom:T53 T54 Sign_symptom 889 898 stricture E27 Sign_symptom:T54 T55 Biological_structure 883 888 ileal T56 Detailed_description 874 882 terminal R28 MODIFY Arg1:T55 Arg2:E27 R29 MODIFY Arg1:T56 Arg2:E27 T57 Biological_structure 903 914 ileo-rectal R30 MODIFY Arg1:T57 Arg2:E26 T58 Coreference 957 970 bowel disease E28 Coreference:T58 R31 IDENTICAL Arg1:E28 Arg2:E1 T59 Medication 1027 1039 azathioprine E29 Medication:T59 T60 Medication 1041 1057 corticosteroiods E30 Medication:T60 T61 Medication 1081 1091 Infliximab E31 Medication:T61 T62 Date 1092 1106 a year earlier E32 Date:T62 T63 Dosage 1062 1077 three infusions R32 MODIFY Arg1:T63 Arg2:E31 T64 Sign_symptom 1123 1157 no extra-intestinal manifestations E33 Sign_symptom:T64 A3 POLARITY E33 NEG T65 Clinical_event 1162 1171 admission E34 Clinical_event:T65 T66 Nonbiological_location 1179 1187 hospital T67 Sign_symptom 1196 1200 thin E35 Sign_symptom:T67 T68 Sign_symptom 1202 1210 afebrile E36 Sign_symptom:T68 T69 Sign_symptom 1226 1237 tachycardia E37 Sign_symptom:T69 T70 Detailed_description 1218 1225 resting R33 MODIFY Arg1:T70 Arg2:E37 T71 Lab_value 1241 1251 125/minute R34 MODIFY Arg1:T71 Arg2:E37 #4 AnnotatorNotes T71 Actually a heart rate, implied by "tachycardia" T72 Diagnostic_procedure 1269 1299 cardio-respiratory examination E38 Diagnostic_procedure:T72 T74 Biological_structure 1316 1323 abdomen T75 Sign_symptom 1338 1344 tender E40 Sign_symptom:T75 T76 Severity 1328 1337 minimally R35 MODIFY Arg1:T76 Arg2:E40 T77 Biological_structure 1356 1365 ileostomy R36 MODIFY Arg1:T77 Arg2:E40 T80 Diagnostic_procedure 1406 1429 Examination of the skin E43 Diagnostic_procedure:T80 T81 Sign_symptom 1444 1452 pustules E44 Sign_symptom:T81 T82 Sign_symptom 1457 1463 crusts E45 Sign_symptom:T82 T83 Biological_structure 1475 1481 elbows T84 Biological_structure 1483 1489 ankles T85 Biological_structure 1494 1498 feet T86 Sign_symptom 1570 1579 synovitis E46 Sign_symptom:T86 T87 Biological_structure 1587 1593 wrists T88 Other_event 1515 1540 The buttocks were spared. E47 Other_event:T88 #5 AnnotatorNotes E47 Kind of a strange way to say that T89 Biological_structure 1595 1619 proximal interphalangeal T90 Biological_structure 1624 1643 metacarpophalangeal T91 Biological_structure 1644 1650 joints R39 MODIFY Arg1:T90 Arg2:T91 R40 MODIFY Arg1:T89 Arg2:T91 T92 Biological_structure 1661 1672 both ankles R41 MODIFY Arg1:T87 Arg2:E46 R42 MODIFY Arg1:T91 Arg2:E46 R43 MODIFY Arg1:T92 Arg2:E46 T93 Diagnostic_procedure 1689 1705 laboratory tests E48 Diagnostic_procedure:T93 T94 Diagnostic_procedure 1715 1726 haemoglobin E49 Diagnostic_procedure:T94 T95 Diagnostic_procedure 1742 1759 white blood count E50 Diagnostic_procedure:T95 T96 Diagnostic_procedure 1774 1783 platelets E51 Diagnostic_procedure:T96 T97 Diagnostic_procedure 1797 1816 C- reactive protein E52 Diagnostic_procedure:T97 T98 Diagnostic_procedure 1831 1861 erythrocyte sedimentation rate E53 Diagnostic_procedure:T98 T99 Lab_value 1730 1740 13.1 gm/dl T100 Lab_value 1760 1772 15.8 × 109/L T101 Lab_value 1784 1795 585 × 109/L T102 Lab_value 1817 1826 37.7 mg/L T103 Lab_value 1862 1870 69 mm/hr R44 MODIFY Arg1:T103 Arg2:E53 R45 MODIFY Arg1:T102 Arg2:E52 R46 MODIFY Arg1:T101 Arg2:E51 R47 MODIFY Arg1:T100 Arg2:E50 R48 MODIFY Arg1:T99 Arg2:E49 R49 SUB_PROCEDURE Arg1:E49 Arg2:E48 R50 SUB_PROCEDURE Arg1:E50 Arg2:E48 R51 SUB_PROCEDURE Arg1:E51 Arg2:E48 R52 SUB_PROCEDURE Arg1:E52 Arg2:E48 R53 SUB_PROCEDURE Arg1:E53 Arg2:E48 T104 Diagnostic_procedure 1872 1876 Urea E54 Diagnostic_procedure:T104 T105 Diagnostic_procedure 1881 1893 electrolytes E55 Diagnostic_procedure:T105 T106 Diagnostic_procedure 1895 1905 complement E56 Diagnostic_procedure:T106 T107 Diagnostic_procedure 1907 1921 urine analysis E57 Diagnostic_procedure:T107 T108 Diagnostic_procedure 1926 1936 microscopy E58 Diagnostic_procedure:T108 T110 Lab_value 2074 2082 negative T111 Diagnostic_procedure 1950 1967 Rheumatoid factor E60 Diagnostic_procedure:T111 T113 Diagnostic_procedure 2098 2112 echocardiogram E62 Diagnostic_procedure:T113 T114 Biological_structure 2084 2097 Transthoracic R54 MODIFY Arg1:T114 Arg2:E62 T115 Sign_symptom 2120 2144 no signs of endocarditis E63 Sign_symptom:T115 A6 POLARITY E63 NEG T116 Diagnostic_procedure 2150 2173 multiple blood cultures E64 Diagnostic_procedure:T116 T117 Lab_value 2179 2186 sterile R55 MODIFY Arg1:T117 Arg2:E64 T118 Diagnostic_procedure 2195 2201 biopsy E65 Diagnostic_procedure:T118 T119 Biological_structure 2190 2194 skin R56 MODIFY Arg1:T119 Arg2:E65 T120 Biological_structure 2228 2240 perivascular T121 Biological_structure 2241 2258 lymphohistiocytic T122 Disease_disorder 2377 2387 vasculitis E66 Disease_disorder:T122 T123 Detailed_description 2359 2375 leukocytoclastic R57 MODIFY Arg1:T123 Arg2:E66 T124 Biological_structure 2259 2269 infiltrate R58 MODIFY Arg1:T121 Arg2:T124 R59 MODIFY Arg1:T120 Arg2:T124 T125 Biological_structure 2285 2296 neutrophils T126 Sign_symptom 2322 2330 necrosis E67 Sign_symptom:T126 T127 Detailed_description 2312 2321 fibrinoid R60 MODIFY Arg1:T127 Arg2:E67 T128 Biological_structure 2334 2341 vessels R61 MODIFY Arg1:T128 Arg2:E67 T129 Medication 2415 2427 prednisolone E68 Medication:T129 T130 Dosage 2409 2414 60 mg R62 MODIFY Arg1:T130 Arg2:E68 T131 Dosage 2428 2435 per day R63 MODIFY Arg1:T131 Arg2:E68 T132 Sign_symptom 2467 2493 resolution of all features E69 Sign_symptom:T132 T133 Detailed_description 2458 2466 complete T134 Detailed_description 2447 2453 prompt R64 MODIFY Arg1:T134 Arg2:E69 R65 MODIFY Arg1:T133 Arg2:E69 R66 CAUSE Arg1:E68 Arg2:E69 T135 Medication 2507 2519 prednisolone E70 Medication:T135 T136 Duration 2632 2658 over the following 3 years E71 Duration:T136 T137 Sign_symptom 2609 2631 without any recurrence E72 Sign_symptom:T137 A7 POLARITY E72 NEG T138 Duration 2540 2568 over the course of one month E73 Duration:T138 T139 Clinical_event 2532 2539 tapered E74 Clinical_event:T139 R67 MODIFY Arg1:E74 Arg2:E70 R68 MODIFY Arg1:E73 Arg2:E74 T112 Diagnostic_procedure 2000 2022 cytoplasmic antibodies E61 Diagnostic_procedure:T112 T140 Detailed_description 1985 1999 antineutrophil R69 MODIFY Arg1:T140 Arg2:E61 T141 Detailed_description 1969 1980 antinuclear R70 MODIFY Arg1:T141 Arg2:E61 T142 Diagnostic_procedure 2024 2037 cryoglobulins E75 Diagnostic_procedure:T142 T143 Diagnostic_procedure 2042 2068 Hepatitis B and C serology E76 Diagnostic_procedure:T143 T144 Clinical_event 66 75 presented E77 Clinical_event:T144 R71 BEFORE Arg1:E1 Arg2:E77 * OVERLAP E77 E8 E3 E4 E5 E6 E7 E9 E10 E11 E12 E13 E14 E15 A8 POLARITY E16 MAYBE_NEG R72 BEFORE Arg1:E17 Arg2:E18 R73 AFTER Arg1:E15 Arg2:E16 * OVERLAP E16 E17 * OVERLAP E18 E19 E20 R74 BEFORE Arg1:E20 Arg2:E21 * OVERLAP E21 E22 E23 T49 Sign_symptom 811 818 fistula E78 Sign_symptom:T49 #6 AnnotatorNotes E78 this isn't really a symptom, but it's relevant R27 MODIFY Arg1:T50 Arg2:E78 R75 AFTER Arg1:E23 Arg2:E78 R76 MODIFY Arg1:E24 Arg2:E78 * OVERLAP E78 E27 R77 AFTER Arg1:E27 Arg2:E26 R78 MODIFY Arg1:E25 Arg2:E26 R79 BEFORE Arg1:E26 Arg2:E29 * OVERLAP E29 E30 E31 E32 R80 BEFORE Arg1:E32 Arg2:E33 R81 BEFORE Arg1:E33 Arg2:E34 R82 MODIFY Arg1:T66 Arg2:E34 * OVERLAP E34 E35 E36 E37 E38 E40 E43 E44 E45 E47 E46 T73 Lab_value 1304 1310 normal R83 MODIFY Arg1:T73 Arg2:E38 R84 MODIFY Arg1:T74 Arg2:E40 T78 Detailed_description 1366 1382 without guarding T79 Detailed_description 1366 1373;1386 1404 without rebound tenderness R37 MODIFY Arg1:T78 Arg2:E40 R38 MODIFY Arg1:T79 Arg2:E40 R85 MODIFY Arg1:T83 Arg2:E43 R86 MODIFY Arg1:T84 Arg2:E43 R87 MODIFY Arg1:T85 Arg2:E43 R88 BEFORE Arg1:E46 Arg2:E48 T109 Lab_value 1942 1948 normal R89 MODIFY Arg1:T109 Arg2:E58 R90 MODIFY Arg1:T109 Arg2:E57 R91 MODIFY Arg1:T109 Arg2:E56 R92 MODIFY Arg1:T109 Arg2:E55 R93 MODIFY Arg1:T109 Arg2:E54 * OVERLAP E48 E54 E55 E56 E57 E58 E60 E61 E75 E76 R94 MODIFY Arg1:T110 Arg2:E60 R95 MODIFY Arg1:T110 Arg2:E61 R96 MODIFY Arg1:T110 Arg2:E75 R97 MODIFY Arg1:T110 Arg2:E76 R98 BEFORE Arg1:E76 Arg2:E62 * OVERLAP E62 E63 E64 R99 BEFORE Arg1:E64 Arg2:E65 R100 MODIFY Arg1:T124 Arg2:E65 R101 MODIFY Arg1:T125 Arg2:T124 * OVERLAP E65 E67 E66 R102 BEFORE Arg1:E66 Arg2:E68 R103 BEFORE Arg1:E68 Arg2:E69 R104 BEFORE Arg1:E69 Arg2:E70 R105 BEFORE Arg1:E70 Arg2:E72 R106 MODIFY Arg1:E71 Arg2:E72