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T1 Age 4 15 36-year-old T2 Sex 16 20 male T3 Disease_disorder 84 87 SSc E1 Disease_disorder:T3 #1 AnnotatorNotes E1 Systemic sclerosis T4 Biological_structure 74 83 cutaneous T5 Detailed_description 66 73 diffuse R1 MODIFY Arg1:T4 Arg2:E1 R2 MODIFY Arg1:T5 Arg2:E1 T6 Clinical_event 125 134 follow-up E2 Clinical_event:T6 A1 POLARITY E2 NEG T7 Medication 138 148 medication E3 Medication:T7 A2 POLARITY E3 NEG T8 History 66 87 diffuse cutaneous SSc T9 Duration 48 54 6-year E4 Duration:T9 T10 Sign_symptom 177 184 malaise E5 Sign_symptom:T10 T11 Sign_symptom 186 199 poor appetite E6 Sign_symptom:T11 T12 Sign_symptom 217 236 shortness of breath E7 Sign_symptom:T12 T13 Detailed_description 205 216 progressive R3 MODIFY Arg1:T13 Arg2:E7 T14 Duration 241 248 1 month E8 Duration:T14 T15 Sign_symptom 253 262 oligouria E9 Sign_symptom:T15 T16 Duration 267 273 3 days E10 Duration:T16 R4 MODIFY Arg1:E8 Arg2:E7 R5 MODIFY Arg1:E8 Arg2:E6 R6 MODIFY Arg1:E8 Arg2:E5 R7 MODIFY Arg1:E10 Arg2:E9 T17 Clinical_event 282 290 admitted E11 Clinical_event:T17 T18 Nonbiological_location 298 306 hospital R8 MODIFY Arg1:T18 Arg2:E11 T19 Disease_disorder 312 325 renal failure E12 Disease_disorder:T19 T20 Sign_symptom 340 345 edema E13 Sign_symptom:T20 T21 Biological_structure 330 339 pulmonary R9 MODIFY Arg1:T21 Arg2:E13 T22 Lab_value 434 447 174/127 mm Hg T23 Diagnostic_procedure 380 394 blood pressure E14 Diagnostic_procedure:T23 T24 Diagnostic_procedure 396 406 pulse rate E15 Diagnostic_procedure:T24 T25 Diagnostic_procedure 412 428 respiratory rate E16 Diagnostic_procedure:T25 T26 Lab_value 449 455 88/min R10 MODIFY Arg1:T22 Arg2:E14 R11 MODIFY Arg1:T26 Arg2:E15 T27 Lab_value 461 467 22/min R12 MODIFY Arg1:T27 Arg2:E16 T28 Diagnostic_procedure 483 502 Laboratory analysis E17 Diagnostic_procedure:T28 T29 Diagnostic_procedure 534 556 white blood cell count E18 Diagnostic_procedure:T29 T30 Diagnostic_procedure 584 594 hemoglobin E19 Diagnostic_procedure:T30 T31 Diagnostic_procedure 619 633 platelet count E20 Diagnostic_procedure:T31 T32 Diagnostic_procedure 666 685 blood urea nitrogen E21 Diagnostic_procedure:T32 T33 Diagnostic_procedure 710 720 creatinine E22 Diagnostic_procedure:T33 T34 Diagnostic_procedure 749 756 calcium E23 Diagnostic_procedure:T34 T35 Diagnostic_procedure 786 796 phosphorus E24 Diagnostic_procedure:T35 T36 Diagnostic_procedure 825 836 haptoglobin E25 Diagnostic_procedure:T36 T37 Diagnostic_procedure 870 891 lactate dehydrogenase E26 Diagnostic_procedure:T37 T38 Lab_value 893 900 547 U/L R13 MODIFY Arg1:T38 Arg2:E26 T39 Lab_value 838 849 <6.56 mg/dL R14 MODIFY Arg1:T39 Arg2:E25 T40 Lab_value 798 807 5.4 mg/dL R15 MODIFY Arg1:T40 Arg2:E24 T41 Lab_value 758 767 8.2 mg/dL R16 MODIFY Arg1:T41 Arg2:E23 T42 Lab_value 722 731 8.9 mg/dL R17 MODIFY Arg1:T42 Arg2:E22 T43 Lab_value 687 695 78 mg/dL R18 MODIFY Arg1:T43 Arg2:E21 T44 Lab_value 635 643 87000/μL R19 MODIFY Arg1:T44 Arg2:E20 T45 Lab_value 596 604 8.6 g/dL R20 MODIFY Arg1:T45 Arg2:E19 T46 Lab_value 558 565 7730/μL R21 MODIFY Arg1:T46 Arg2:E18 T47 Diagnostic_procedure 926 936 urinalysis E27 Diagnostic_procedure:T47 T48 Lab_value 948 971 proteinuria score of 2+ T49 Lab_value 973 982 200 mg/dL R22 MODIFY Arg1:T48 Arg2:E27 R23 MODIFY Arg1:T49 Arg2:E27 T50 Diagnostic_procedure 985 1007 white blood cell count E28 Diagnostic_procedure:T50 T51 Diagnostic_procedure 1037 1057 red blood cell count E29 Diagnostic_procedure:T51 R24 SUB_PROCEDURE Arg1:E28 Arg2:E27 R25 SUB_PROCEDURE Arg1:E29 Arg2:E27 T52 Lab_value 1011 1031 3–5/high power field T53 Lab_value 1061 1083 25–50/high power field R26 MODIFY Arg1:T52 Arg2:E28 R27 MODIFY Arg1:T53 Arg2:E29 T54 Diagnostic_procedure 1089 1107 autoimmune profile E30 Diagnostic_procedure:T54 T55 Diagnostic_procedure 1121 1141 antinuclear antibody E31 Diagnostic_procedure:T55 R28 SUB_PROCEDURE Arg1:E31 Arg2:E30 T56 Lab_value 1151 1156 1:320 R29 MODIFY Arg1:T56 Arg2:E31 T57 Lab_value 1158 1174 speckles; normal R30 MODIFY Arg1:T57 Arg2:E31 T58 Lab_value 1176 1181 <1:40 R31 MODIFY Arg1:T58 Arg2:T57 T59 Diagnostic_procedure 1194 1204 anti-Scl70 E32 Diagnostic_procedure:T59 T60 Diagnostic_procedure 1206 1230 anti-double-stranded DNA E33 Diagnostic_procedure:T60 T61 Diagnostic_procedure 1232 1239 anti-Ro E34 Diagnostic_procedure:T61 T62 Diagnostic_procedure 1241 1248 anti-La E35 Diagnostic_procedure:T62 T63 Diagnostic_procedure 1254 1280 anticardiolipin antibodies E36 Diagnostic_procedure:T63 T64 Lab_value 1290 1298 negative R32 MODIFY Arg1:T64 Arg2:E36 R33 MODIFY Arg1:T64 Arg2:E35 R34 MODIFY Arg1:T64 Arg2:E34 R35 MODIFY Arg1:T64 Arg2:E33 R36 MODIFY Arg1:T64 Arg2:E32 T65 Diagnostic_procedure 1307 1315 echogram E37 Diagnostic_procedure:T65 T66 Biological_structure 1300 1306 Kidney R37 MODIFY Arg1:T66 Arg2:E37 T67 Sign_symptom 1325 1356 decreased bilateral kidney size E38 Sign_symptom:T67 T68 Sign_symptom 1365 1379 hydronephrosis E39 Sign_symptom:T68 A3 POLARITY E39 NEG T69 Sign_symptom 1476 1481 edema E40 Sign_symptom:T69 T70 Biological_structure 1466 1475 pulmonary R38 MODIFY Arg1:T70 Arg2:E40 T71 Sign_symptom 1486 1495 oligouria E41 Sign_symptom:T71 T72 Date 1501 1514 3 days before E42 Date:T72 T73 Disease_disorder 1580 1593 renal failure E43 Disease_disorder:T73 T74 Detailed_description 1563 1579 acute-on-chronic R39 MODIFY Arg1:T74 Arg2:E43 T75 Disease_disorder 1627 1630 SRC E44 Disease_disorder:T75 #2 AnnotatorNotes E44 scleroderma renal crisis T76 Disease_disorder 1664 1677 renal failure E45 Disease_disorder:T76 T77 Sign_symptom 1710 1716 anemia E46 Sign_symptom:T77 T78 Detailed_description 1683 1699 microangiopathic T79 Detailed_description 1700 1709 hemolytic R40 MODIFY Arg1:T79 Arg2:E46 R41 MODIFY Arg1:T78 Arg2:E46 T80 Sign_symptom 1721 1733 hypertension E47 Sign_symptom:T80 T81 Sign_symptom 1799 1830 deterioration in renal function E48 Sign_symptom:T81 T82 Sign_symptom 1835 1841 anuria E49 Sign_symptom:T82 T83 Therapeutic_procedure 1879 1891 hemodialysis E50 Therapeutic_procedure:T83 T84 Detailed_description 1871 1878 regular R42 MODIFY Arg1:T84 Arg2:E50 T85 Date 1908 1920 After 3 days E51 Date:T85 T86 Medication 1922 1931 captopril E52 Medication:T86 A4 POLARITY E52 NEG T87 Medication 1947 1957 amlodipine E53 Medication:T87 T88 Sign_symptom 2010 2015 cough E54 Sign_symptom:T88 T89 Severity 1990 1996 severe T90 Detailed_description 1998 2009 intolerable R43 MODIFY Arg1:T90 Arg2:E54 R44 MODIFY Arg1:T89 Arg2:E54 T91 Diagnostic_procedure 2061 2084 systolic blood pressure E55 Diagnostic_procedure:T91 T92 Lab_value 2089 2099 controlled T93 Lab_value 2100 2125 between 140 and 180 mm Hg R45 MODIFY Arg1:T92 Arg2:E55 R46 MODIFY Arg1:T93 Arg2:E55 T94 Date 2144 2157 3 weeks after E56 Date:T94 T95 Coreference 2188 2200 hemodialysis E57 Coreference:T95 R47 IDENTICAL Arg1:E57 Arg2:E50 T96 Disease_disorder 2257 2273 seizure disorder E58 Disease_disorder:T96 T97 Detailed_description 2244 2256 tonic-clonic T98 Detailed_description 2232 2243 generalized R48 MODIFY Arg1:T97 Arg2:E58 R49 MODIFY Arg1:T98 Arg2:E58 T99 Diagnostic_procedure 2283 2302 computed tomography E59 Diagnostic_procedure:T99 T100 Diagnostic_procedure 2304 2306 CT E60 Diagnostic_procedure:T100 T101 Biological_structure 2277 2282 brain R50 MODIFY Arg1:T101 Arg2:E59 R51 IDENTICAL Arg1:E60 Arg2:E59 T102 Disease_disorder 2338 2345 infarct E61 Disease_disorder:T102 T103 Detailed_description 2330 2337 lacunar T104 Severity 2324 2329 small R52 MODIFY Arg1:T103 Arg2:E61 R53 MODIFY Arg1:T104 Arg2:E61 T105 Biological_structure 2355 2374 left basal ganglion R54 MODIFY Arg1:T105 Arg2:E61 T106 Disease_disorder 2396 2406 hemorrhage E62 Disease_disorder:T106 A5 POLARITY E62 NEG T107 Disease_disorder 2416 2423 infarct E63 Disease_disorder:T107 A6 POLARITY E63 NEG T108 Severity 2410 2415 large R55 MODIFY Arg1:T108 Arg2:E63 T109 Biological_structure 2383 2395 intracranial R56 MODIFY Arg1:T109 Arg2:E62 T110 Medication 2468 2483 anticonvulsants E64 Medication:T110 A7 POLARITY E64 NEG T111 Clinical_event 2513 2523 discharged E65 Clinical_event:T111 T112 Nonbiological_location 2524 2528 home R57 MODIFY Arg1:T112 Arg2:E65 T113 Frequency 2585 2598 thrice weekly T114 Therapeutic_procedure 2572 2584 hemodialysis E66 Therapeutic_procedure:T114 R58 MODIFY Arg1:T113 Arg2:E66 T115 Sign_symptom 2429 2436 seizure E67 Sign_symptom:T115 A8 POLARITY E67 NEG T116 Date 2612 2624 1 week after E68 Date:T116 T117 Sign_symptom 2673 2681 headache E69 Sign_symptom:T117 T118 Sign_symptom 2686 2694 vomiting E70 Sign_symptom:T118 T119 Sign_symptom 2700 2709 confusion E71 Sign_symptom:T119 T120 Sign_symptom 2757 2764 seizure E72 Sign_symptom:T120 T121 Detailed_description 2744 2756 tonic-clonic T122 Detailed_description 2732 2743 generalized R59 MODIFY Arg1:T121 Arg2:E72 R60 MODIFY Arg1:T122 Arg2:E72 T123 Detailed_description 2660 2672 sudden-onset R61 MODIFY Arg1:T123 Arg2:E69 T124 Clinical_event 2769 2778 presented E73 Clinical_event:T124 T125 Nonbiological_location 2786 2806 emergency department R62 MODIFY Arg1:T125 Arg2:E73 T126 Diagnostic_procedure 2814 2828 blood pressure E74 Diagnostic_procedure:T126 T127 Lab_value 2832 2845 183/100 mm Hg R63 MODIFY Arg1:T127 Arg2:E74 T128 Diagnostic_procedure 2847 2861 platelet count E75 Diagnostic_procedure:T128 T129 Lab_value 2865 2875 149,000/μL R64 MODIFY Arg1:T129 Arg2:E75 T130 Diagnostic_procedure 2877 2886 serum LDH E76 Diagnostic_procedure:T130 T131 Lab_value 2890 2897 332 U/L R65 MODIFY Arg1:T131 Arg2:E76 T132 Diagnostic_procedure 2905 2927 peripheral blood smear E77 Diagnostic_procedure:T132 T133 Lab_value 2928 2958 containing 2–3 schizocytes/HPF R66 MODIFY Arg1:T133 Arg2:E77 T134 Diagnostic_procedure 2974 2976 CT E78 Diagnostic_procedure:T134 T135 Biological_structure 2968 2973 Brain R67 MODIFY Arg1:T135 Arg2:E78 T136 Lab_value 2986 3004 no interval change R68 MODIFY Arg1:T136 Arg2:E78 T137 Diagnostic_procedure 3010 3025 lumbar puncture E79 Diagnostic_procedure:T137 T138 Lab_value 3035 3057 traumatic tapping only R69 MODIFY Arg1:T138 Arg2:E79 T139 Diagnostic_procedure 3073 3087 fluid cultures E80 Diagnostic_procedure:T139 T140 Biological_structure 3059 3072 Cerebrospinal R70 MODIFY Arg1:T140 Arg2:E80 T141 Lab_value 3093 3101 negative R71 MODIFY Arg1:T141 Arg2:E80 T142 Detailed_description 3106 3114 bacteria T143 Detailed_description 3116 3128 mycobacteria T144 Detailed_description 3134 3141 viruses R72 MODIFY Arg1:T142 Arg2:T141 R73 MODIFY Arg1:T143 Arg2:T141 R74 MODIFY Arg1:T144 Arg2:T141 T145 Diagnostic_procedure 3149 3175 magnetic resonance imaging E81 Diagnostic_procedure:T145 T146 Diagnostic_procedure 3177 3180 MRI E82 Diagnostic_procedure:T146 R75 IDENTICAL Arg1:E82 Arg2:E81 T147 Biological_structure 3143 3148 Brain R76 MODIFY Arg1:T147 Arg2:E81 T148 Sign_symptom 3199 3213 hyperintensity E83 Sign_symptom:T148 T149 Detailed_description 3189 3198 bilateral R77 MODIFY Arg1:T149 Arg2:E83 T150 Biological_structure 3221 3249 occipital and parietal lobes R78 MODIFY Arg1:T150 Arg2:E83 T151 Detailed_description 3255 3307 fluid-attenuated inversion recovery (FLAIR) sequence R79 MODIFY Arg1:T151 Arg2:E83 T152 Disease_disorder 3357 3361 PRES E84 Disease_disorder:T152 #3 AnnotatorNotes E84 Posterior reversible encephalopathy syndrome T153 Medication 3374 3383 captopril E85 Medication:T153 T154 Dosage 3405 3423 25 mg thrice daily R80 MODIFY Arg1:T154 Arg2:E85 T155 Diagnostic_procedure 3545 3558 mental status E86 Diagnostic_procedure:T155 T156 Lab_value 3571 3577 normal R81 MODIFY Arg1:T156 Arg2:E86 T157 Date 3585 3591 3 days E87 Date:T157 T158 Therapeutic_procedure 3610 3625 plasma exchange E88 Therapeutic_procedure:T158 A9 POLARITY E88 NEG T159 Diagnostic_procedure 3643 3646 MRI E89 Diagnostic_procedure:T159 T160 Biological_structure 3654 3659 brain R82 MODIFY Arg1:T160 Arg2:E89 T161 Date 3660 3674 2 months later E90 Date:T161 T162 Sign_symptom 3714 3719 edema E91 Sign_symptom:T162 T163 Biological_structure 3705 3713 cerebral R83 MODIFY Arg1:T163 Arg2:E91 A10 POLARITY E91 NEG T164 Disease_disorder 3752 3756 PRES E92 Disease_disorder:T164 T165 Detailed_description 3740 3751 SRC-related R84 MODIFY Arg1:T165 Arg2:E92 T166 Sign_symptom 3807 3831 full neurologic recovery E93 Sign_symptom:T166 T167 Diagnostic_procedure 3837 3851 renal function E94 Diagnostic_procedure:T167 T168 Lab_value 3852 3867 did not improve R85 MODIFY Arg1:T168 Arg2:E94 T169 Therapeutic_procedure 3884 3892 dialysis E95 Therapeutic_procedure:T169 T170 Detailed_description 3893 3902 dependent R86 MODIFY Arg1:T170 Arg2:E95 R87 MODIFY Arg1:E4 Arg2:E1 * OVERLAP E4 E1 E2 E3 R88 BEFORE Arg1:E3 Arg2:E5 * OVERLAP E5 E6 E7 E8 R89 BEFORE Arg1:E8 Arg2:E9 * OVERLAP E9 E10 R90 BEFORE Arg1:E10 Arg2:E11 * OVERLAP E11 E12 E13 E14 E15 E16 E17 E27 E30 E32 E33 E34 E35 E36 E37 E38 E39 R91 SUB_PROCEDURE Arg1:E18 Arg2:E17 R92 SUB_PROCEDURE Arg1:E19 Arg2:E17 R93 SUB_PROCEDURE Arg1:E20 Arg2:E17 R94 SUB_PROCEDURE Arg1:E21 Arg2:E17 R95 SUB_PROCEDURE Arg1:E22 Arg2:E17 R96 SUB_PROCEDURE Arg1:E23 Arg2:E17 R97 SUB_PROCEDURE Arg1:E24 Arg2:E17 R98 SUB_PROCEDURE Arg1:E25 Arg2:E17 R99 SUB_PROCEDURE Arg1:E26 Arg2:E17 R100 AFTER Arg1:E39 Arg2:E40 * OVERLAP E40 E41 E42 R101 BEFORE Arg1:E42 Arg2:E43 R102 BEFORE Arg1:E43 Arg2:E44 * OVERLAP E44 E45 E46 E47 E96 E48 E49 E50 T171 Medication 1766 1775 captopril E96 Medication:T171 R103 BEFORE Arg1:E50 Arg2:E51 * OVERLAP E51 E52 E53 E54 E55 R104 BEFORE Arg1:E55 Arg2:E56 * OVERLAP E56 E57 E58 E59 E61 E62 E63 E67 E64 R105 BEFORE Arg1:E64 Arg2:E65 * OVERLAP E65 E66 R106 BEFORE Arg1:E66 Arg2:E68 * OVERLAP E68 E69 E70 E71 E72 R107 BEFORE Arg1:E72 Arg2:E73 * OVERLAP E73 E74 E75 E76 E77 E78 E79 E80 E81 E83 R108 BEFORE Arg1:E83 Arg2:E84 * OVERLAP E84 E85 R109 BEFORE Arg1:E85 Arg2:E86 * OVERLAP E86 E87 E88 R110 BEFORE Arg1:E88 Arg2:E89 * OVERLAP E89 E90 E91 E92 R111 BEFORE Arg1:E92 Arg2:E93 * OVERLAP E93 E94 E95