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T1 Age 2 13 46-year-old T2 Sex 14 19 woman T3 History 38 58 Graves' disease (GD) T4 Clinical_event 63 74 transferred E1 Clinical_event:T4 T5 Nonbiological_location 82 102 emergency department T6 Disease_disorder 119 122 DKA E2 Disease_disorder:T6 #1 AnnotatorNotes E2 Diabetic ketoacidosis R1 MODIFY Arg1:T5 Arg2:E1 T7 Sign_symptom 140 150 polydipsia E3 Sign_symptom:T7 T8 Sign_symptom 152 160 polyuria E4 Sign_symptom:T8 T9 Sign_symptom 166 173 fatigue E5 Sign_symptom:T9 T10 Duration 188 218 four months prior to admission E6 Duration:T10 T11 Duration 255 262 1-month E7 Duration:T11 T12 Sign_symptom 276 289 appetite loss E8 Sign_symptom:T12 T13 Sign_symptom 310 321 weight loss E9 Sign_symptom:T13 T14 Lab_value 305 309 7 kg R2 MODIFY Arg1:T14 Arg2:E9 T15 Sign_symptom 323 330 fatigue E10 Sign_symptom:T15 T16 Sign_symptom 332 338 nausea E11 Sign_symptom:T16 T17 Sign_symptom 344 352 sweating E12 Sign_symptom:T17 T18 History 383 444 GD, diagnosed at 42 years of age and managed with methimazole T19 Disease_disorder 383 385 GD E13 Disease_disorder:T19 #2 AnnotatorNotes E13 This is labeled as a disease_disorder here and not above because a date is specified here. T20 Date 387 415 diagnosed at 42 years of age E14 Date:T20 T21 Medication 433 444 methimazole E15 Medication:T21 T22 Medication 484 502 anti-thyroid drugs E16 Medication:T22 T23 Lab_value 463 478 poor compliance R3 MODIFY Arg1:T23 Arg2:E16 T24 History 508 563 denied a family history of thyroid diseases or diabetes T25 Date 565 592 Three days before admission E17 Date:T25 T26 Disease_disorder 622 633 influenza A E18 Disease_disorder:T26 T27 Nonbiological_location 639 654 nearby hospital T28 Medication 660 681 oseltamivir phosphate E19 Medication:T28 T29 Nonbiological_location 705 725 emergency department T30 Clinical_event 731 740 presented E20 Clinical_event:T30 T31 Sign_symptom 746 756 drowsiness E21 Sign_symptom:T31 T32 Diagnostic_procedure 763 779 body temperature E22 Diagnostic_procedure:T32 T33 Lab_value 783 788 37.0℃ R4 MODIFY Arg1:T33 Arg2:E22 T34 Diagnostic_procedure 790 804 blood pressure E23 Diagnostic_procedure:T34 T35 Lab_value 808 818 90/60 mmHg R5 MODIFY Arg1:T35 Arg2:E23 T36 Diagnostic_procedure 820 830 heart rate E24 Diagnostic_procedure:T36 T37 Lab_value 834 841 200 bpm R6 MODIFY Arg1:T37 Arg2:E24 T38 Diagnostic_procedure 843 859 respiratory rate E25 Diagnostic_procedure:T38 T39 Lab_value 863 877 32 breaths/min T40 Diagnostic_procedure 879 896 oxygen saturation E26 Diagnostic_procedure:T40 T41 Lab_value 900 903 99% R7 MODIFY Arg1:T41 Arg2:E26 T42 Lab_value 907 920 5 L nasal air R8 MODIFY Arg1:T42 Arg2:E26 T43 Diagnostic_procedure 928 946 Glasgow coma scale E27 Diagnostic_procedure:T43 T44 Diagnostic_procedure 948 951 GCS E28 Diagnostic_procedure:T44 R9 IDENTICAL Arg1:E28 Arg2:E27 T45 Lab_value 962 964 14 R10 MODIFY Arg1:T45 Arg2:E27 T46 Diagnostic_procedure 970 990 clinical examination E29 Diagnostic_procedure:T46 T47 Sign_symptom 1010 1016 goiter E30 Sign_symptom:T47 T48 Detailed_description 1002 1009 diffuse R11 MODIFY Arg1:T48 Arg2:E30 T49 Detailed_description 1022 1046 bilateral exophthalmoses R12 MODIFY Arg1:T49 Arg2:E30 T50 Diagnostic_procedure 1074 1085 auscultated E31 Diagnostic_procedure:T50 T51 Biological_structure 1052 1057 lungs T52 Lab_value 1063 1068 clear R13 MODIFY Arg1:T52 Arg2:T51 R14 MODIFY Arg1:T51 Arg2:E31 T53 Biological_structure 1091 1098 abdomen T54 Biological_structure 1128 1132 skin T55 Lab_value 1103 1107 soft T56 Sign_symptom 1116 1122 tender E32 Sign_symptom:T56 A1 POLARITY E32 NEG T57 Lab_value 1137 1141 warm T58 Lab_value 1146 1149 wet R15 MODIFY Arg1:T57 Arg2:T54 R16 MODIFY Arg1:T58 Arg2:T54 T59 Sign_symptom 1178 1183 edema E33 Sign_symptom:T59 A2 POLARITY E33 NEG T60 Biological_structure 1162 1177 lower extremity R17 MODIFY Arg1:T60 Arg2:E33 T61 Diagnostic_procedure 1189 1206 electrocardiogram E34 Diagnostic_procedure:T61 T62 Sign_symptom 1221 1232 tachycardia E35 Sign_symptom:T62 T63 Detailed_description 1214 1220 marked R18 MODIFY Arg1:T63 Arg2:E35 T64 Disease_disorder 1238 1257 atrial fibrillation E36 Disease_disorder:T64 T65 Diagnostic_procedure 1271 1281 radiograph E37 Diagnostic_procedure:T65 T66 Biological_structure 1265 1270 chest R19 MODIFY Arg1:T66 Arg2:E37 T67 Lab_value 1286 1292 normal R20 MODIFY Arg1:T67 Arg2:E37 T68 Diagnostic_procedure 1298 1313 laboratory data E38 Diagnostic_procedure:T68 T69 Sign_symptom 1384 1402 metabolic acidosis E39 Sign_symptom:T69 T70 Diagnostic_procedure 1417 1431 plasma glucose E40 Diagnostic_procedure:T70 T71 Lab_value 1441 1450 472 mg/dL R21 MODIFY Arg1:T71 Arg2:E40 T72 Lab_value 1407 1416 increased R22 MODIFY Arg1:T72 Arg2:E40 T73 Diagnostic_procedure 1465 1470 HbA1c E41 Diagnostic_procedure:T73 T74 Lab_value 1480 1485 13.7% R23 MODIFY Arg1:T74 Arg2:E41 T75 Lab_value 1455 1464 increased R24 MODIFY Arg1:T75 Arg2:E41 T76 Diagnostic_procedure 1500 1521 free triiodothyronine E42 Diagnostic_procedure:T76 T77 Lab_value 1490 1499 increased R25 MODIFY Arg1:T77 Arg2:E42 T78 Lab_value 1531 1542 6.440 pg/mL R26 MODIFY Arg1:T78 Arg2:E42 T79 Diagnostic_procedure 1550 1564 free thyroxine E43 Diagnostic_procedure:T79 T80 Lab_value 1574 1585 2.830 ng/dL R27 MODIFY Arg1:T80 Arg2:E43 T81 Diagnostic_procedure 1594 1616 suppressed thyrotropin E44 Diagnostic_procedure:T81 T82 Lab_value 1632 1644 0.005 μIU/mL R28 MODIFY Arg1:T82 Arg2:E44 T83 Disease_disorder 1841 1855 thyrotoxicosis E45 Disease_disorder:T83 T84 Sign_symptom 1857 1902 symptoms involving the central nervous system E46 Sign_symptom:T84 T85 Sign_symptom 1904 1915 tachycardia E47 Sign_symptom:T85 T86 Sign_symptom 1921 1946 gastrointestinal symptoms E48 Sign_symptom:T86 T87 Disease_disorder 1988 1991 DKA E49 Disease_disorder:T87 T88 Disease_disorder 1996 2009 thyroid storm E50 Disease_disorder:T88 T89 Diagnostic_procedure 1667 1725 diagnostic criteria of Burch & Wartofsky for thyroid storm E51 Diagnostic_procedure:T89 T90 Lab_value 1657 1659 55 #3 AnnotatorNotes T90 Diagnostic score R29 MODIFY Arg1:T90 Arg2:E51 T91 Diagnostic_procedure 1735 1805 diagnostic criteria of the Japan Thyroid Association for thyroid storm E52 Diagnostic_procedure:T91 T92 Lab_value 1816 1825 satisfied R30 MODIFY Arg1:T92 Arg2:E52 T93 Clinical_event 2014 2022 admitted E53 Clinical_event:T93 T94 Nonbiological_location 2030 2057 medical intensive care unit T95 Diagnostic_procedure 2070 2080 monitoring E54 Diagnostic_procedure:T95 T96 Therapeutic_procedure 2085 2094 treatment E55 Therapeutic_procedure:T96 R31 MODIFY Arg1:T94 Arg2:E53 T97 Medication 2172 2179 insulin E56 Medication:T97 T98 Administration 2160 2171 intravenous T99 Administration 2180 2184 drip R32 MODIFY Arg1:T98 Arg2:E56 R33 MODIFY Arg1:T99 Arg2:E56 T100 Therapeutic_procedure 2212 2225 fluid therapy E57 Therapeutic_procedure:T100 T101 Administration 2200 2211 intravenous R34 MODIFY Arg1:T101 Arg2:E57 T102 Detailed_description 2189 2199 aggressive R35 MODIFY Arg1:T102 Arg2:E57 T103 Disease_disorder 2231 2244 thyroid storm E58 Disease_disorder:T103 T104 Disease_disorder 2250 2252 GD E59 Disease_disorder:T104 T105 Medication 2282 2296 hydrocortisone E60 Medication:T105 T106 Administration 2270 2281 intravenous R36 MODIFY Arg1:T106 Arg2:E60 T107 Dosage 2297 2317 100 mg every 8 hours R37 MODIFY Arg1:T107 Arg2:E60 T108 Medication 2324 2340 potassium iodine E61 Medication:T108 T109 Administration 2319 2323 oral R38 MODIFY Arg1:T109 Arg2:E61 T110 Dosage 2341 2360 50 mg every 6 hours R39 MODIFY Arg1:T110 Arg2:E61 T111 Medication 2371 2382 methimazole E62 Medication:T111 T112 Dosage 2383 2402 20 mg every 6 hours R40 MODIFY Arg1:T112 Arg2:E62 T113 Administration 2366 2370 oral R41 MODIFY Arg1:T113 Arg2:E62 T114 History 2431 2437 asthma T115 Medication 2439 2462 landiolol hydrochloride E63 Medication:T115 T116 Dosage 2518 2532 4-12 μg/kg/min R42 MODIFY Arg1:T116 Arg2:E63 T117 Date 2563 2568 Day 3 E64 Date:T117 T118 Sign_symptom 2574 2585 tachycardia E65 Sign_symptom:T118 A3 POLARITY E65 NEG T119 Medication 2604 2627 landiolol hydrochloride E66 Medication:T119 A4 POLARITY E66 NEG T120 Date 2649 2654 Day 6 E67 Date:T120 T121 Diagnostic_procedure 2660 2682 white blood cell count E68 Diagnostic_procedure:T121 T122 Lab_value 2700 2715 2,800 cells/mm3 R43 MODIFY Arg1:T122 Arg2:E68 T123 Lab_value 2717 2753 neutrophils, 44.2% (1,238 cells/mm3) R44 MODIFY Arg1:T123 Arg2:E68 T124 Medication 2756 2767 Methimazole E69 Medication:T124 A5 POLARITY E69 NEG T125 Sign_symptom 2813 2824 neutropenia E70 Sign_symptom:T125 A6 POLARITY E70 UNCERTAIN T126 Clinical_event 2856 2864 referred E71 Clinical_event:T126 T127 Nonbiological_location 2871 2888 endocrine surgeon R45 MODIFY Arg1:T127 Arg2:E71 T128 Therapeutic_procedure 2894 2907 thyroidectomy E72 Therapeutic_procedure:T128 T129 Date 2925 2931 Day 32 E73 Date:T129 T130 Clinical_event 2941 2951 discharged E74 Clinical_event:T130 T131 Date 2973 2979 Day 37 E75 Date:T131 T132 Medication 3013 3020 insulin E76 Medication:T132 T133 Administration 3021 3029 infusion T134 Dosage 2998 3012 multiple daily R46 MODIFY Arg1:T133 Arg2:E76 R47 MODIFY Arg1:T134 Arg2:E76 T135 Medication 3034 3062 levothyroxine sodium hydrate E77 Medication:T135 T136 Diagnostic_procedure 3072 3099 immunological investigation E78 Diagnostic_procedure:T136 T137 Diagnostic_procedure 3128 3175 anti-glutamic acid decarboxylase (GAD) antibody E79 Diagnostic_procedure:T137 T138 Diagnostic_procedure 3177 3218 anti-insulinoma antigen 2 (IA-2) antibody E80 Diagnostic_procedure:T138 T139 Diagnostic_procedure 3224 3244 insulin autoantibody E81 Diagnostic_procedure:T139 T140 Lab_value 3109 3124 elevated levels R48 MODIFY Arg1:T140 Arg2:E79 R49 MODIFY Arg1:T140 Arg2:E80 R50 MODIFY Arg1:T140 Arg2:E81 R51 SUB_PROCEDURE Arg1:E79 Arg2:E78 R52 SUB_PROCEDURE Arg1:E80 Arg2:E78 R53 SUB_PROCEDURE Arg1:E81 Arg2:E78 T141 Disease_disorder 3262 3265 T1D E82 Disease_disorder:T141 T142 Diagnostic_procedure 3271 3308 intravenous glucagon stimulation test E83 Diagnostic_procedure:T142 T143 Diagnostic_procedure 3405 3419 plasma glucose E84 Diagnostic_procedure:T143 T144 Lab_value 3432 3435 139 T145 Lab_value 3440 3449 152 mg/dL R54 MODIFY Arg1:T144 Arg2:E84 R55 MODIFY Arg1:T145 Arg2:E84 T146 Detailed_description 3453 3461 baseline R56 MODIFY Arg1:T146 Arg2:T144 T147 Detailed_description 3466 3475 6 minutes #4 AnnotatorNotes T147 Not a time, but part of a diagnostic R57 MODIFY Arg1:T147 Arg2:T145 T148 Diagnostic_procedure 3509 3524 serum C-peptide E85 Diagnostic_procedure:T148 T149 Lab_value 3537 3540 0.8 T150 Lab_value 3545 3554 1.3 ng/mL R58 MODIFY Arg1:T149 Arg2:E85 R59 MODIFY Arg1:T150 Arg2:E85 T151 Detailed_description 3558 3566 baseline T152 Detailed_description 3571 3580 6 minutes R60 MODIFY Arg1:T151 Arg2:T149 R61 MODIFY Arg1:T152 Arg2:T150 T153 Biological_structure 3328 3341 blood samples R62 MODIFY Arg1:T153 Arg2:E83 T154 Detailed_description 3342 3399 for glucose and C-peptide taken at baseline and 6 minutes R63 MODIFY Arg1:T154 Arg2:E83 A7 POLARITY E2 UNCERTAIN * OVERLAP E1 E2 R64 AFTER Arg1:E2 Arg2:E3 * OVERLAP E3 E4 E5 E6 R65 BEFORE Arg1:E6 Arg2:E7 * OVERLAP E7 E8 E9 E10 E11 E12 R66 AFTER Arg1:E12 Arg2:E13 * OVERLAP E13 E14 E15 E16 R67 BEFORE Arg1:E16 Arg2:E17 T155 Clinical_event 607 616 diagnosed E86 Clinical_event:T155 R68 MODIFY Arg1:T27 Arg2:E86 * OVERLAP E17 E86 E18 E19 R69 MODIFY Arg1:T29 Arg2:E20 R70 BEFORE Arg1:E19 Arg2:E20 * OVERLAP E20 E21 E22 E23 E24 E25 E26 E27 E29 E30 E31 E32 E33 E34 E35 E36 E37 E38 E87 E39 E40 E41 E42 E43 E44 E51 E52 E45 E46 E47 E48 R71 MODIFY Arg1:T39 Arg2:E25 #5 AnnotatorNotes T45 Diagnostic criteria R72 MODIFY Arg1:T53 Arg2:E32 R73 MODIFY Arg1:T55 Arg2:T53 T156 Diagnostic_procedure 1348 1363 laboratory data E87 Diagnostic_procedure:T156 T157 Clinical_event 1973 1982 diagnosed E88 Clinical_event:T157 R74 BEFORE Arg1:E48 Arg2:E88 * OVERLAP E88 E49 E50 R75 BEFORE Arg1:E50 Arg2:E53 * OVERLAP E53 E54 E55 E56 E57 E58 E59 E60 E61 E62 E63 R76 BEFORE Arg1:E63 Arg2:E64 * OVERLAP E64 E65 E66 R77 BEFORE Arg1:E66 Arg2:E67 * OVERLAP E67 E68 E69 E70 T158 Detailed_description 2793 2812 methimazole-induced R78 MODIFY Arg1:T158 Arg2:E70 R79 BEFORE Arg1:E70 Arg2:E71 * OVERLAP E71 E72 E73 R80 BEFORE Arg1:E73 Arg2:E74 T159 Nonbiological_location 2961 2969 hospital R81 MODIFY Arg1:T159 Arg2:E74 * OVERLAP E74 E75 E76 E77 R82 BEFORE Arg1:E77 Arg2:E78 * OVERLAP E78 E82 E83 E84 E85