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The 25-mg/kg dose increased these parameters by 62.2%, 51.7%, and 158.5%, respectively

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With the additional impact of hyperhomocysteinemia on vitamin B12 deficiency, the hemolysis is more severe and occur in both intravascular and intramedullary settings, resulting in a drastic reduction of circulating red blood cell mass as was seen in our case

The deficiency becomes one possibility among a long list, and it is not always the first to be investigated