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T1 Age 2 13 20-year-old T2 History 14 32 previously healthy T3 Personal_background 33 40 Bengali T4 Sex 41 44 man T5 Clinical_event 45 54 presented E1 Clinical_event:T5 T6 Nonbiological_location 62 70 hospital R1 MODIFY Arg1:T6 Arg2:E1 T7 Sign_symptom 76 82 anuria E2 Sign_symptom:T7 T8 Disease_disorder 106 120 encephalopathy E3 Disease_disorder:T8 A1 POLARITY E3 MAYBE_POS T9 Detailed_description 99 105 uremic R2 MODIFY Arg1:T9 Arg2:E3 T10 Sign_symptom 569 584 acidotic breath E4 Sign_symptom:T10 T11 Sign_symptom 553 563 tachypneic E5 Sign_symptom:T11 T12 Date 122 136 Ten days prior E6 Date:T12 T13 Sign_symptom 201 205 pain E7 Sign_symptom:T13 T14 Biological_structure 185 200 upper abdominal T15 Severity 178 184 severe R3 MODIFY Arg1:T14 Arg2:E7 R4 MODIFY Arg1:T15 Arg2:E7 T16 Sign_symptom 210 218 vomiting E8 Sign_symptom:T16 T17 Therapeutic_procedure 236 243 treated E9 Therapeutic_procedure:T17 T18 Nonbiological_location 249 270 primary care facility R5 MODIFY Arg1:T18 Arg2:E9 T19 Disease_disorder 298 310 pancreatitis E10 Disease_disorder:T19 A2 POLARITY E10 MAYBE_POS T20 Detailed_description 292 297 acute R6 MODIFY Arg1:T20 Arg2:E10 T21 Sign_symptom 316 332 initial symptoms E11 Sign_symptom:T21 A3 TREND E11 DEC T22 Sign_symptom 372 378 anuric E12 Sign_symptom:T22 T23 Sign_symptom 383 394 disoriented E13 Sign_symptom:T23 T24 Clinical_event 408 419 transferred E14 Clinical_event:T24 T25 Nonbiological_location 427 435 hospital R7 MODIFY Arg1:T25 Arg2:E14 T26 Clinical_event 463 475 presentation E15 Clinical_event:T26 T27 Sign_symptom 509 517 agitated E16 Sign_symptom:T27 T28 Sign_symptom 519 527 restless E17 Sign_symptom:T28 T29 Sign_symptom 533 544 disoriented E18 Sign_symptom:T29 T30 Severity 500 508 severely R8 MODIFY Arg1:T30 Arg2:E16 R9 MODIFY Arg1:T30 Arg2:E17 R10 MODIFY Arg1:T30 Arg2:E18 T31 Sign_symptom 597 602 edema E19 Sign_symptom:T31 T32 Biological_structure 591 596 pedal R11 MODIFY Arg1:T32 Arg2:E19 T33 Severity 586 590 Mild R12 MODIFY Arg1:T33 Arg2:E19 T34 Diagnostic_procedure 629 652 jugular venous pressure E20 Diagnostic_procedure:T34 T35 Lab_value 657 667 not raised R13 MODIFY Arg1:T35 Arg2:E20 T36 Diagnostic_procedure 673 678 pulse E21 Diagnostic_procedure:T36 T37 Lab_value 683 699 112 beats/minute R14 MODIFY Arg1:T37 Arg2:E21 T38 Diagnostic_procedure 705 719 blood pressure E22 Diagnostic_procedure:T38 T39 Lab_value 724 735 140/90 mmHg R15 MODIFY Arg1:T39 Arg2:E22 T40 Diagnostic_procedure 745 761 body temperature E23 Diagnostic_procedure:T40 T41 Lab_value 766 771 98 °F R16 MODIFY Arg1:T41 Arg2:E23 T42 Sign_symptom 792 802 irritation E24 Sign_symptom:T42 A4 POLARITY E24 NEG T43 Biological_structure 782 791 meningeal R17 MODIFY Arg1:T43 Arg2:E24 T44 Diagnostic_procedure 824 840 plantar response E25 Diagnostic_procedure:T44 T45 Lab_value 845 865 bilaterally extensor R18 MODIFY Arg1:T45 Arg2:E25 T46 Diagnostic_procedure 906 917 examination E26 Diagnostic_procedure:T46 T47 Biological_structure 925 938 other systems R19 MODIFY Arg1:T47 Arg2:E26 T48 Lab_value 943 955 unremarkable R20 MODIFY Arg1:T48 Arg2:E26 T49 Diagnostic_procedure 871 877 fundus E27 Diagnostic_procedure:T49 T50 Lab_value 878 900 could not be evaluated R21 MODIFY Arg1:T50 Arg2:E27 T51 Diagnostic_procedure 961 982 laboratory parameters E28 Diagnostic_procedure:T51 T52 Disease_disorder 1002 1019 renal dysfunction E29 Disease_disorder:T52 T53 Diagnostic_procedure 1021 1037 serum creatinine E30 Diagnostic_procedure:T53 R22 SUB_PROCEDURE Arg1:E30 Arg2:E28 T54 Lab_value 1038 1046 13 mg/dl R23 MODIFY Arg1:T54 Arg2:E30 T55 Diagnostic_procedure 1048 1058 serum urea E31 Diagnostic_procedure:T55 T56 Lab_value 1059 1068 293 mg/dl R24 MODIFY Arg1:T56 Arg2:E31 T57 Lab_value 1071 1077 raised T58 Diagnostic_procedure 1078 1096 pancreatic enzymes E32 Diagnostic_procedure:T58 R25 MODIFY Arg1:T57 Arg2:E32 R26 SUB_PROCEDURE Arg1:E31 Arg2:E28 R27 SUB_PROCEDURE Arg1:E32 Arg2:E28 T59 Diagnostic_procedure 1098 1111 serum amylase E33 Diagnostic_procedure:T59 T60 Lab_value 1112 1119 249 U/L R28 MODIFY Arg1:T60 Arg2:E33 R29 SUB_PROCEDURE Arg1:E33 Arg2:E32 T61 Diagnostic_procedure 1147 1159 serum lipase E34 Diagnostic_procedure:T61 T62 Lab_value 1160 1167 227 U/L R30 MODIFY Arg1:T62 Arg2:E34 R31 SUB_PROCEDURE Arg1:E34 Arg2:E32 T63 Diagnostic_procedure 1198 1212 liver function E35 Diagnostic_procedure:T63 T64 Lab_value 1191 1197 normal R32 MODIFY Arg1:T64 Arg2:E35 R33 SUB_PROCEDURE Arg1:E35 Arg2:E28 T65 Diagnostic_procedure 1220 1235 serum bilirubin E36 Diagnostic_procedure:T65 T66 Lab_value 1236 1245 0.9 mg/dl R34 MODIFY Arg1:T66 Arg2:E36 R35 SUB_PROCEDURE Arg1:E36 Arg2:E35 T67 Diagnostic_procedure 1247 1271 alanine aminotransferase E37 Diagnostic_procedure:T67 R36 SUB_PROCEDURE Arg1:E37 Arg2:E35 T68 Lab_value 1272 1278 38 U/L R37 MODIFY Arg1:T68 Arg2:E37 T69 Diagnostic_procedure 1280 1306 aspartate aminotransferase E38 Diagnostic_procedure:T69 T70 Lab_value 1307 1313 35 U/L R38 MODIFY Arg1:T70 Arg2:E38 R39 SUB_PROCEDURE Arg1:E38 Arg2:E35 T71 Diagnostic_procedure 1315 1335 alkaline phosphatase E39 Diagnostic_procedure:T71 T72 Lab_value 1336 1343 122 U/L R40 MODIFY Arg1:T72 Arg2:E39 R41 SUB_PROCEDURE Arg1:E39 Arg2:E35 T73 Diagnostic_procedure 1345 1358 serum albumin E40 Diagnostic_procedure:T73 T74 Lab_value 1359 1365 37 g/L R42 MODIFY Arg1:T74 Arg2:E40 R43 SUB_PROCEDURE Arg1:E40 Arg2:E35 T75 Diagnostic_procedure 1375 1384 potassium E41 Diagnostic_procedure:T75 T76 Lab_value 1368 1374 normal R44 MODIFY Arg1:T76 Arg2:E41 R45 SUB_PROCEDURE Arg1:E41 Arg2:E28 T77 Lab_value 1386 1396 5.1 mmol/L R46 MODIFY Arg1:T77 Arg2:E41 T78 Lab_value 1399 1405 normal T79 Diagnostic_procedure 1406 1417 bicarbonate E42 Diagnostic_procedure:T79 T80 Lab_value 1419 1428 19 mmol/L R47 MODIFY Arg1:T80 Arg2:E42 R48 MODIFY Arg1:T78 Arg2:E42 T81 Lab_value 1435 1441 normal T82 Diagnostic_procedure 1442 1455 triglycerides E43 Diagnostic_procedure:T82 T83 Lab_value 1457 1466 173 mg/dl R49 MODIFY Arg1:T83 Arg2:E43 R50 MODIFY Arg1:T81 Arg2:E43 R51 SUB_PROCEDURE Arg1:E42 Arg2:E28 R52 SUB_PROCEDURE Arg1:E43 Arg2:E28 T84 Diagnostic_procedure 1473 1492 serological markers E44 Diagnostic_procedure:T84 T85 Diagnostic_procedure 1504 1526 antinuclear antibodies E45 Diagnostic_procedure:T85 R53 SUB_PROCEDURE Arg1:E45 Arg2:E44 T86 Diagnostic_procedure 1528 1577 cytoplasmic antineutrophil cytoplasmic antibodies E46 Diagnostic_procedure:T86 T87 Diagnostic_procedure 1579 1628 perinuclear antineutrophil cytoplasmic antibodies E47 Diagnostic_procedure:T87 T88 Diagnostic_procedure 1630 1632 C3 E48 Diagnostic_procedure:T88 T89 Diagnostic_procedure 1638 1640 C4 E49 Diagnostic_procedure:T89 R54 SUB_PROCEDURE Arg1:E46 Arg2:E44 R55 SUB_PROCEDURE Arg1:E47 Arg2:E44 R56 SUB_PROCEDURE Arg1:E48 Arg2:E44 R57 SUB_PROCEDURE Arg1:E49 Arg2:E44 T90 Lab_value 1647 1667 within normal limits R58 MODIFY Arg1:T90 Arg2:E44 T91 Diagnostic_procedure 1672 1685 ultrasonogram E50 Diagnostic_procedure:T91 T92 Biological_structure 1699 1706 abdomen R59 MODIFY Arg1:T92 Arg2:E50 T93 Lab_value 1711 1723 unremarkable R60 MODIFY Arg1:T93 Arg2:E50 T94 Diagnostic_procedure 1751 1770 computed tomography E51 Diagnostic_procedure:T94 T95 Diagnostic_procedure 1772 1774 CT E52 Diagnostic_procedure:T95 R61 IDENTICAL Arg1:E52 Arg2:E51 T96 Detailed_description 1729 1750 non-contrast-enhanced R62 MODIFY Arg1:T96 Arg2:E51 T97 Disease_disorder 1810 1822 pancreatitis E53 Disease_disorder:T97 A5 POLARITY E53 MAYBE_POS T98 Detailed_description 1804 1809 acute R63 MODIFY Arg1:T98 Arg2:E53 T99 Diagnostic_procedure 1836 1843 kidneys E54 Diagnostic_procedure:T99 T100 Lab_value 1849 1861 unremarkable R64 MODIFY Arg1:T100 Arg2:E54 T101 Disease_disorder 1916 1919 AKI E55 Disease_disorder:T101 #1 AnnotatorNotes E55 acute kidney injury T102 Disease_disorder 1930 1942 pancreatitis E56 Disease_disorder:T102 T103 Detailed_description 1924 1929 acute R65 MODIFY Arg1:T103 Arg2:E56 T104 Therapeutic_procedure 1951 1963 hemodialysis E57 Therapeutic_procedure:T104 T105 Detailed_description 1944 1950 Urgent R66 MODIFY Arg1:T105 Arg2:E57 T106 Therapeutic_procedure 2017 2029 hemodialysis E58 Therapeutic_procedure:T106 T107 Detailed_description 2001 2013 two sessions R67 MODIFY Arg1:T107 Arg2:E58 T108 Diagnostic_procedure 2035 2057 level of consciousness E59 Diagnostic_procedure:T108 T109 Lab_value 2058 2066 improved R68 MODIFY Arg1:T109 Arg2:E59 T110 Disease_disorder 2098 2109 visual loss E60 Disease_disorder:T110 T111 Severity 2089 2097 profound R69 MODIFY Arg1:T111 Arg2:E60 T112 Sign_symptom 2139 2158 perception of light E61 Sign_symptom:T112 T113 Diagnostic_procedure 2162 2185 funduscopic examination E62 Diagnostic_procedure:T113 T114 Sign_symptom 2193 2210 retinal whitening E63 Sign_symptom:T114 T115 Sign_symptom 2225 2244 cotton wool exudate E64 Sign_symptom:T115 T116 Severity 2215 2224 extensive R70 MODIFY Arg1:T116 Arg2:E64 T117 Sign_symptom 2257 2276 Purtscher’s flecken E65 Sign_symptom:T117 T118 Disease_disorder 2301 2324 Purtscher’s retinopathy E66 Disease_disorder:T118 T119 Medication 2347 2365 methylprednisolone E67 Medication:T119 T120 Dosage 2385 2395 once daily T121 Dosage 2367 2370 1 g T122 Administration 2371 2384 intravenously R71 MODIFY Arg1:T121 Arg2:E67 R72 MODIFY Arg1:T120 Arg2:E67 R73 MODIFY Arg1:T122 Arg2:E67 T123 Administration 2336 2346 parenteral R74 MODIFY Arg1:T123 Arg2:E67 T124 Dosage 2326 2335 High-dose R75 MODIFY Arg1:T124 Arg2:E67 T125 Duration 2400 2406 3 days E68 Duration:T125 T126 Diagnostic_procedure 2430 2461 evaluation of renal dysfunction E69 Diagnostic_procedure:T126 T127 Diagnostic_procedure 2471 2477 biopsy E70 Diagnostic_procedure:T127 T128 Biological_structure 2465 2470 renal R76 MODIFY Arg1:T128 Arg2:E70 T129 Diagnostic_procedure 2492 2518 histopathological findings E71 Diagnostic_procedure:T129 T130 Disease_disorder 2540 2563 renal cortical necrosis E72 Disease_disorder:T130 T131 History 2585 2628 denied substance abuse or alcohol ingestion T132 History 2633 2708 did not consume any nephrotoxic drugs or herbal products in the recent past T133 History 2710 2772 No history suggesting connective tissue diseases was available T134 Sign_symptom 2803 2814 hypotension E73 Sign_symptom:T134 A6 POLARITY E73 NEG T135 Disease_disorder 2906 2918 pancreatitis E74 Disease_disorder:T135 T136 Detailed_description 2900 2905 acute R77 MODIFY Arg1:T136 Arg2:E74 T137 Disease_disorder 2936 2959 renal cortical necrosis E75 Disease_disorder:T137 T138 Disease_disorder 2971 2974 AKI E76 Disease_disorder:T138 T139 Disease_disorder 2979 3002 Purtscher’s retinopathy E77 Disease_disorder:T139 T140 Disease_disorder 3033 3042 blindness E78 Disease_disorder:T140 T141 Detailed_description 3023 3032 bilateral T142 Severity 3014 3022 complete R78 MODIFY Arg1:T142 Arg2:E78 R79 MODIFY Arg1:T141 Arg2:E78 R80 CAUSE Arg1:E75 Arg2:E76 R81 CAUSE Arg1:E77 Arg2:E78 T143 Outcome 3047 3051 died E79 Outcome:T143 T144 Date 3052 3067 16 months after E80 Date:T144 T145 Disease_disorder 3136 3148 pancreatitis E81 Disease_disorder:T145 T146 Detailed_description 3130 3135 acute R82 MODIFY Arg1:T146 Arg2:E81 T147 Detailed_description 3110 3119 recurrent R83 MODIFY Arg1:T147 Arg2:E81 R84 CAUSE Arg1:E81 Arg2:E79 T148 Therapeutic_procedure 3198 3210 hemodialysis E82 Therapeutic_procedure:T148 T149 Detailed_description 3186 3197 maintenance R85 MODIFY Arg1:T149 Arg2:E82 T150 Diagnostic_procedure 3225 3239 renal function E83 Diagnostic_procedure:T150 T151 Lab_value 3240 3255 did not recover R86 MODIFY Arg1:T151 Arg2:E83 T152 Diagnostic_procedure 3291 3306 finger-counting E84 Diagnostic_procedure:T152 T153 Lab_value 3310 3316 2 feet R87 MODIFY Arg1:T153 Arg2:E84 T154 Diagnostic_procedure 3268 3274 vision E85 Diagnostic_procedure:T154 T155 Lab_value 3279 3287 improved R88 MODIFY Arg1:T155 Arg2:E85 R89 SUB_PROCEDURE Arg1:E84 Arg2:E85 * OVERLAP E1 E2 E3 R90 AFTER Arg1:E3 Arg2:E6 * OVERLAP E6 E7 E8 R91 BEFORE Arg1:E8 Arg2:E9 * OVERLAP E9 E10 R92 BEFORE Arg1:E10 Arg2:E11 * OVERLAP E11 E12 E13 R93 BEFORE Arg1:E13 Arg2:E14 R94 BEFORE Arg1:E14 Arg2:E15 * OVERLAP E15 E16 E17 E18 E5 E4 E19 E20 E21 E22 E23 E24 E25 E27 E26 E28 E44 E50 E51 E53 E54 E55 E56 R95 BEFORE Arg1:E56 Arg2:E57 R96 BEFORE Arg1:E57 Arg2:E58 * OVERLAP E58 E59 E60 E61 E62 E63 E64 E65 E66 R97 BEFORE Arg1:E66 Arg2:E67 * OVERLAP E67 E68 E69 E70 E71 E72 E73 R98 BEFORE Arg1:E73 Arg2:E74 * OVERLAP E74 E75 E76 E77 E78 R99 BEFORE Arg1:E78 Arg2:E79 * OVERLAP E79 E80 E81 R100 AFTER Arg1:E81 Arg2:E82 * OVERLAP E82 E83 E85