{"meta":{"exportedAt":"2026-10-12T06:14:07.401Z","formatVersion":2,"selection":{"q":"self-medication","system":"","harm":"","context":"","country":"","role":"","relation":"","evidence":"","year":"","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":1,"coverage":{"cases":1,"countries":1,"languages":1,"unknownLocation":0,"locationPending":0,"unknownLanguage":0,"unknownDate":0,"lawsuits":0,"regulatory":0,"minors":0,"coreRelations":1,"contextualRelations":0,"mixedRelations":0,"unknownRelations":0,"relationPending":0,"relationUnknown":0},"countingNote":"Distinct public cases in this selection. People counts apply within individual cases only; cross-case person overlap has not been resolved. No population incidence estimate.","affectedCountNote":"Interpret person counts with affectedCountStatus and the reported effects. Unquantified zeros are placeholders, not a measured zero.","source":"AI incidents","publisher":"NOPE","url":"https://nope.net/incidents","license":"CC BY 4.0"},"incidents":[{"id":"2025-case-report-deepseek-guided-fever-self-diagnosis-unsupervised-colchicine-liver-enzymes","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'Since early childhood, he had experienced recurrent inflammatory attacks characterized by fever, severe migratory abdominal pain, arthralgia involving the knees, feet and hips, lower-limb myalgia, and intermittent erythematous skin lesions.'; 'Despite almost 3 decades of symptoms, extensive investigations, including contrast-enhanced abdominal CT and MRI, gastroscopy, colonoscopy, and urological assessment, failed to establish a diagnosis.'","relation":"supports","source_id":"s1"}],"assertion":"A man in his thirties had had recurrent febrile attacks since early childhood, and nearly three decades of investigations had produced no diagnosis.","causal_attribution":"The patient's history as taken and written up by the treating clinicians."},{"id":"c2","status":"reported","evidence":[{"locator":"'the patient began a dialogue with the publicly available LLM (DeepSeek-R1-0528) on June 28, 2025.'; 'FMF was presented as the leading diagnosis'; 'Although the model continued to recommend rheumatological assessment and MEFV testing, its language became increasingly confident, at times describing the presentation as classic or highly suggestive of FMF. It also repeatedly discussed a diagnostic trial of colchicine and provided specific dosing suggestions before specialist assessment.'; 'it explicitly advised that colchicine should only be initiated with specialist approval and appropriate laboratory monitoring.'","relation":"supports","source_id":"s1"}],"assertion":"In a dialogue with DeepSeek-R1-0528 begun on 28 June 2025, the model came to present familial Mediterranean fever as the leading diagnosis in increasingly confident language and repeatedly discussed a diagnostic trial of colchicine with specific dosing before specialist assessment, while also recommending specialist evaluation and, in its final reply on his other medication, advising colchicine only with specialist approval and monitoring.","causal_attribution":"The authors' description of the conversation, which they include as a supplement that was not inspected here."},{"id":"c3","status":"reported","evidence":[{"locator":"'Motivated by the LLM-generated diagnostic hypothesis, the patient independently obtained commercial genetic MEFV testing at Alfa Labs, Egypt, which identified 2 pathogenic MEFV variants'; 'Before specialist assessment, he obtained colchicine himself from a pharmacy in Egypt and initiated treatment at a dose of 0.5 mg twice daily without prior specialist supervision.'; 'the patient nevertheless translated the generated diagnostic hypothesis into autonomous genetic testing and self-medication.'","relation":"supports","source_id":"s1"}],"assertion":"Motivated by the model's hypothesis, he arranged commercial genetic testing in Egypt, which found two pathogenic MEFV variants, and obtained colchicine from a pharmacy in Egypt, starting 0.5 mg twice daily without specialist supervision.","causal_attribution":"The patient's account as reported by the treating clinicians; the authors state the motivation."},{"id":"c4","status":"reported","evidence":[{"locator":"'Following colchicine initiation, recurrent febrile attacks ceased completely for the first time since childhood. However, alanine aminotransferase increased to 160 U/L. In view of the elevated liver enzymes, colchicine was temporarily discontinued, and liver enzyme levels were monitored closely by the primary care physician.'; 'colchicine treatment was resumed at a dose of 0.5 mg/d under close supervision.'","relation":"supports","source_id":"s1"}],"assertion":"After he started colchicine his febrile attacks ceased, but his alanine aminotransferase rose to 160 U/L; colchicine was temporarily discontinued under primary-care monitoring and later resumed at 0.5 mg daily under close supervision.","causal_attribution":"Clinical course reported by the authors; the liver tests were monitored by his primary care physician."},{"id":"c5","status":"documented","evidence":[{"locator":"'Based on the characteristic lifelong clinical phenotype, Mediterranean ancestry, suggestive family history, identification of 2 pathogenic MEFV variants, and clinical response to colchicine, the diagnosis of FMF was confirmed'; 'The patient has remained free of attacks with regular clinical and laboratory follow-up.'","relation":"supports","source_id":"s1"}],"assertion":"At the authors' clinic in February 2026 the diagnosis of familial Mediterranean fever was confirmed, and he has remained free of attacks under follow-up.","causal_attribution":"The treating specialists' own diagnostic finding, directly recorded in their report."},{"id":"c6","status":"reported","evidence":[{"locator":"'although the model consistently recommended specialist evaluation before treatment initiation, the patient nevertheless translated the generated diagnostic hypothesis into autonomous genetic testing and self-medication. The subsequent elevation of liver enzymes illustrates that even clinically accurate diagnostic suggestions may inadvertently encourage harmful behavior if patients perceive the model as sufficiently authoritative.'; 'generic recommendations to seek specialist advice may not sufficiently mitigate risk when they are accompanied by confident diagnostic language and actionable treatment instructions'","relation":"supports","source_id":"s1"}],"assertion":"The authors write that, although the model consistently recommended specialist evaluation, the patient turned its hypothesis into autonomous testing and self-medication, that the liver-enzyme rise shows accurate suggestions can encourage harmful behaviour when the model seems authoritative, and that generic advice to see a specialist may not mitigate risk alongside confident language and actionable treatment instructions.","causal_attribution":"The authors' interpretation of the model's role; the model also advised specialist supervision, so causation is alleged."}],"effects":[{"label":"liver enzyme rise during colchicine self-treatment started without specialist supervision, so the drug was paused","claim_id":"c4","direction":"negative"},{"label":"attacks stopped and a long-missed diagnosis was later confirmed by specialists","claim_id":"c5","direction":"positive"}],"sources":[{"id":"s1","url":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13651492/fullTextXML","kind":"clinical_case_report","access":"read","language":"en","translation_note":"Full text of the peer-reviewed case report read as Europe PMC fullTextXML for PMC13651492 (HTTP 200) on 2026-10-12: abstract, case description, discussion, consent and AI-use declarations. Written by the treating clinicians. The supplementary DeepSeek conversation was not inspected.","independence_group":"eular-rheumatol-open-pauz-2026-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health"],"unknowns":["What DeepSeek replied in each turn; the supplementary transcript was not inspected.","Where the patient held the dialogue and where his liver enzymes were monitored.","Whether the liver-enzyme rise had any cause other than colchicine, including the other long-term medication he was taking; the report does not discuss alternatives."],"geography":{"basis":"The report says the patient obtained the genetic test at a laboratory in Egypt and the colchicine from a pharmacy in Egypt (EG). It does not say where he held the DeepSeek dialogue or where his liver enzymes were monitored. He later presented to the authors' clinic in Hamburg; that confirmation visit is not used as the event location, and birthplace is not used as residence. No court proceeding is reported.","court_countries":[],"event_countries":["EG"],"affected_person_countries":[]},"publication":{"basis":"Core case (communicated_with): the treating clinicians report that a DeepSeek dialogue presented a rare fever syndrome as the leading diagnosis with specific colchicine dosing, and that the patient then self-medicated without supervision and developed a liver-enzyme rise that led to a pause in treatment. The account is mixed: the model also advised specialist supervision and the patient's attacks stopped, so causation is alleged and severity low.","reviewed_on":"2026-10-12"},"ai_involvement":{"basis":"The treating clinicians, who include the full conversation as a supplement, report that DeepSeek-R1-0528 progressively presented familial Mediterranean fever as the leading diagnosis in increasingly confident language and repeatedly discussed a diagnostic colchicine trial with specific dosing before specialist assessment, and that the patient, motivated by that hypothesis, arranged genetic testing and started colchicine unsupervised, after which his liver enzymes rose. They also report that the model repeatedly advised specialist supervision.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: man self-treated with colchicine after a DeepSeek dialogue pointed to a rare fever syndrome; liver enzymes rose before specialist review","summary":"Clinicians at the University Medical Center Hamburg-Eppendorf report in EULAR Rheumatology Open (published 29 September 2026) a man in his thirties with nearly three decades of unexplained febrile attacks who, in a dialogue with DeepSeek begun on 28 June 2025, saw the model's differential narrow to familial Mediterranean fever (FMF). The authors write that the model repeatedly recommended specialist assessment but also discussed a diagnostic trial of colchicine with specific dosing. Motivated by the hypothesis, he arranged commercial genetic testing and obtained colchicine from a pharmacy in Egypt, starting it without specialist supervision. His attacks stopped, but his alanine aminotransferase rose to 160 U/L and colchicine was paused and later resumed at a lower dose. FMF was confirmed when he presented to the clinic in February 2026. The authors write that the case illustrates how patient-facing models may facilitate recognition of rare autoinflammatory diseases, and that confident diagnostic language combined with actionable treatment advice may also encourage unsupervised testing and self-medication.","incidentDate":"2025-06-28","incidentKind":"single_event","incidentDatePrecision":"day","exposurePattern":"single_interaction","reportedDate":"2026-09-29","aiSystem":"DeepSeek (DeepSeek-R1-0528, the publicly available model), used by the patient in an iterative diagnostic dialogue (case report by the treating clinicians)","aiProduct":"DeepSeek","aiCompany":"DeepSeek","severity":"low","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["medical_deterioration"],"harmOutcomeSummary":"The treating clinicians report that after the DeepSeek dialogue the patient started colchicine without specialist supervision and his alanine aminotransferase rose to 160 U/L, so the drug was paused and resumed at a lower dose; they also report that his attacks stopped and that the diagnosis was later confirmed.","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"One patient, the subject of the case report. Exact 1.","victimAgeRange":"adult","platformType":"chatbot","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13651492/fullTextXML","primarySourceLabel":"EULAR Rheumatology Open, 29 September 2026: Pauz et al., LLM-supported self-diagnosis and self-treatment of FMF (case report, Europe PMC full text)","firstPublishedAt":"2026-10-12T03:14:06.074846+00:00","updatedAt":"2026-10-12T03:14:06.074846+00:00","scopeVersion":"facts-v3","tags":["deepseek","case-report","self-medication","self-diagnosis","colchicine","rare-disease","communicated-with"]}]}