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Common reasons include: Pernicious anemia , an autoimmune condition affecting intrinsic factor production Gastrointestinal disorders, such as Crohns disease or celiac disease Prolonged use of certain medications, like proton pump inhibitors Knowing these causes helps spot at-risk people

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Remarks Clinical examination should be always performed with the child placed in a supine and frog-legged position on the examination bed, or on the parents lap [61, 62]