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These reasons, while understandable from a procedural standpoint, can be clinically and emotionally detrimental to a patient with Pernicious Anemia who is symptomatic and in need of treatment

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"Urate Transporter ABCG2 Function and Asymptomatic Hyperuricemia: A Retrospective Cohort Study of CKD Progression"

doi: 10.1038/ijo.2014.153