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Rapidly progressing maculopathy with severe photoreceptor and ganglion cell loss, renal thrombotic microangiopathy, hemolytic uremic syndrome, pulmonary hypertension, and pulmonary thrombotic events have also been described in adult-onset cobalamin C defect (42
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Much of the research framing treats it as an orally administered compound, and in practitioner circles it circulates in oral/sublingual forms (capsules, or the reconstituted solution taken sublingually)
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