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Patients with this condition or those with a family history suggestive of Lebers disease should avoid cyanocobalamin-containing products or use alternative forms of vitamin B12 such as hydroxocobalamin under careful medical supervision

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Seek immediate emergency care (call 911) for sudden severe shortness of breath, chest pain, rapid heart rate, facial or throat swelling, wheezing, blue discoloration of lips, inability to speak in complete sentences, or confusion

J Biol Chem 2011

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