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most of these patients present in the neonatal period with feeding difficulties, failure to thrive, neurologic deterioration, megaloblastic anemia, variable renal and liver failure, cardiomyopathy, pneumonia, and retinopathy
[5] Nevertheless, any signs of hypersensitivity (such as a diffuse rash, wheezing, or feeling of throat tightness) warrant stopping the injection and seeking prompt medical care
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