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10.1016/j.cbi.2013.09.020 41 CreutzenbergO.BellmannB.KorolewitzR.KochW.MangelsdorfI.TillmannT.et al (2012)

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Deficiency causes megaloblastic anemia abnormally large, dysfunctional red cells that impair oxygen delivery, producing fatigue, shortness of breath, and pallor