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Non-specific symptoms and signs are loss of appetite, diarrhoea, fatigue and weakness, shortness of breath, low blood pressure, confusion, and change in mental states.9 29 Classical manifestations include Hunters glossitis, megaloblastic anaemia, and subacute combined degeneration of spinal cord (Table 29)

Elevated plasma vitamin B12 concentrations are independent predictors of in-hospital mortality in adult patients at nutritional risk

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