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The lungs and kidneys are frequently involved, resulting in life-threatening pulmonary hemorrhage and rapidly progressive renal failure often requiring renal replacement therapy

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If it does not, the most defensible general approach is cold-chain handling: freezer storage for long-term dry powder, refrigerator storage for short-term reconstituted solution, and no casual room-temperature storage after mixing

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While B12 is important for overall health and energy, it's not typically the go-to for intentional weight gain