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Hematological analysis revealed alanine aminotransferase 39 U/L, triglycerides 2.36 mmol/L, and cholesterol 5.65 mmol/L

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Tissue-level deficiency of cobalamin is associated with an increase in the urinary and serum concentrations of an organic acid called methylmalonic acid, which is an alternative product of a cobalamin dependent pathway within the mitochondria

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