22:
114:
144:
192:
cannot progress from the G2 growth stage to the mitosis (M) stage. This leads to continuing cell growth without division, which presents as macrocytosis. Megaloblastic anemia has a rather slow onset, especially when compared to that of other anemias. The defect in red cell DNA synthesis is most often
912:
Nations, S. P.; Boyer, P. J.; Love, L. A.; Burritt, M. F.; Butz, J. A.; Wolfe, G. I.; Hynan, L. S.; Reisch, J.; Trivedi, J. R. (2008-08-26). "Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease".
1036:
Megaloblastic anemia is a blood disorder in which there is anemia with larger-than-normal red blood cells. Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body
1184:
1161:
598:
deficiency is but one among the conditions that can lead to dysfunction of this enzyme and a buildup of its substrate, methylmalonic acid, the elevated level of which can be detected in the urine and blood.
702:
nuclei ("senile neutrophil"). This is thought to be due to decreased production and a compensatory prolonged lifespan for circulating neutrophils, which increase numbers of nuclear segments with age.
1074:
Savage DG, Lindenbaum J, Stabler SP, Allen RH (1994). "Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies".
565:
can result from a number of mechanisms, including those listed above. For determination of cause, further patient history, testing, and empirical therapy may be clinically indicated.
384:
559:
is a finding that normally can and should be treated by injections, supplementation, or dietary or lifestyle advice, but it is not a diagnosis. Hypovitaminosis B
231:(defined as the presence of neutrophils with six or more lobes or the presence of more than 3% of neutrophils with at least five lobes). These hypersegmented
813:
964:
Spain, Rebecca I.; Leist, Thomas P.; De Sousa, Eduardo A. (February 2009). "When metals compete: a case of copper-deficiency myeloneuropathy and anemia".
860:
32:
482:
resulting from an excess of zinc from unusually high oral consumption of zinc-containing denture-fixation creams has been found to be a cause.
769:
Normal levels of both methylmalonic acid and total homocysteine rule out clinically significant cobalamin deficiency with virtual certainty.
1441:
1646:
1015:
1797:
1299:
1749:
1571:
675:
1641:
93:
1581:
65:
578:
and folate deficiencies. The level of methylmalonic acid is not elevated in folic acid deficiency. Direct measurement of blood
788:
72:
1458:
1613:
474:
79:
1622:
1593:
1111:
896:
223:
The pathological state of megaloblastosis is characterized by many large immature and dysfunctional red blood cells (
51:
1653:
1525:
312:
589:
366:
61:
1586:
1292:
793:
1607:
1515:
864:
1680:
1632:
582:
remains the gold standard because the test for elevated methylmalonic acid is not specific enough. Vitamin B
1822:
1537:
1689:
1563:
1427:
1382:
1267:
853:
668:
212:
that poison DNA production directly, such as some chemotherapeutic or antimicrobial agents (for example
1627:
1453:
530:
1554:
1544:
1532:
1285:
742:
699:
228:
40:
1827:
1520:
1199:
511:
occur as a result of arrested nuclear maturation so the cells show nuclear-cytoplasmic asynchrony.
469:
184:
defect that can lead to an undersupply of oxygen. Megaloblastic anemia results from inhibition of
151:
Peripheral blood smear showing hypersegmented neutrophils, characteristic of megaloblastic anemia.
86:
1725:
1576:
819:
660:
36:
1716:
1377:
695:
297:
248:
198:
1239:
1023:
47:
1696:
1463:
886:
1706:
1701:
1509:
318:
1049:
775:(not normally checked in a patient suspected of megaloblastic anemia) shows megaloblastic
8:
1755:
1500:
1308:
1188:
463:
840:
745:(LDH) level. The isozyme is LDH-2 which is typical of the serum and hematopoietic cells.
1787:
1760:
1365:
997:
946:
926:
833:
753:
572:(methylmalonate) can provide an indirect method for partially differentiating Vitamin B
569:
1792:
1782:
1741:
1736:
1731:
1672:
1504:
1493:
1483:
1417:
1400:
1391:
1373:
1335:
1210:
1091:
1087:
989:
981:
938:
930:
892:
727:
500:
479:
334:
268:
202:
173:
156:
1193:
1001:
950:
1488:
1473:
1412:
1250:
1116:
1083:
973:
922:
685:
count due to destruction of fragile and abnormal megaloblastic erythroid precursor.
425:
267:, a molecule produced by cells in the stomach that is required for B12 absorption (
264:
236:
1667:
1268:
GeneReview/NCBI/NIH/UW entry on
Thiamine-Responsive Megaloblastic Anemia Syndrome
1204:
734:
457:
396:
278:
194:
185:
1684:
1312:
1253:
1215:
709:
649:
623:
613:
609:
519:
284:
209:
181:
1277:
1178:
1174:
1170:
1816:
985:
934:
508:
492:
450:
362:
326:
308:
143:
1327:
993:
942:
749:
705:
682:
526:
429:
415:
254:
217:
213:
1153:
1095:
518:, most megaloblasts are destroyed prior to entering the peripheral blood (
1478:
1436:
1234:
977:
776:
772:
515:
504:
305:
292:
272:
224:
861:"Megaloblastic (Pernicious) Anemia - Lucile Packard Children's Hospital"
1447:
664:
653:
641:
616:
was performed in the past to help determine the nature of the vitamin B
439:
435:
411:
340:
232:
189:
161:
50:
if you can. Unsourced or poorly sourced material may be challenged and
188:
during red blood cell production. When DNA synthesis is impaired, the
1245:
721:
715:
579:
522:
445:
357:
349:
689:
380:
1272:
373:
288:
208:
Megaloblastic anemia not due to hypovitaminosis may be caused by
1356:
1165:
885:
Bain, Barbara J.; Bates, Imelda; Laffan, Mike A. (2016-08-11).
421:
353:
177:
1073:
496:
402:
1119:; Kasper, D. L.; Hauser SL, S. L.; et al. (eds.).
911:
841:"Megaloblastic Anemia: Overview - eMedicine Hematology"
495:
in the rapidly dividing cells and to a lesser extent,
1143:
529:) to peripheral blood but they are destroyed by the
1110:
963:
602:Due to the lack of available radioactive Vitamin B
329:anesthesia (usually requires repeated instances).
1814:
588:is one necessary prosthetic group to the enzyme
541:The gold standard for the diagnosis of Vitamin B
1307:
884:
392:Combined Deficiency: vitamin B12 & folate.
239:(using a diagnostic smear of a blood sample).
205:. Loss of micronutrients may also be a cause.
46:Please review the contents of the article and
1293:
1442:Glucose-6-phosphate dehydrogenase deficiency
888:Dacie and Lewis Practical Haematology E-Book
547:deficiency is a low blood level of Vitamin B
383:and factors (e.g., enzymes) responsible for
1326:
765:Increased homocysteine in folate deficiency
612:is now largely a historical artifact. The
1798:Hereditary persistence of fetal hemoglobin
1300:
1286:
1121:Harrison's Principles of Internal Medicine
395:Inherited Pyrimidine Synthesis Disorders:
283:Biological competition for vitamin B12 by
142:
1750:Mean corpuscular hemoglobin concentration
1572:Warm antibody autoimmune hemolytic anemia
1108:
676:mean corpuscular hemoglobin concentration
503:are also impaired. Therefore, unbalanced
1815:
1123:(18th ed.). New York: McGraw-Hill
718:(larger than normal RBCs) are present.
708:(increased variation in RBC size) and
644:can point towards vitamin deficiency:
295:, or infection by the marine parasite
1355:
1281:
789:List of circulatory system conditions
1459:triosephosphate isomerase deficiency
1112:"Chapter 105. Megaloblastic Anemias"
1054:The Lecturio Medical Concept Library
626:was that it often included Vitamin B
525:). Some can escape the bone marrow (
356:, rapid cellular proliferation, and
15:
1614:paroxysmal nocturnal hemoglobinuria
1582:Donath–Landsteiner hemolytic anemia
1562:
966:Nature Clinical Practice. Neurology
814:"Anemia. Blood patient information"
730:(chromosomal remnant) also present.
475:Congenital dyserythropoietic anemia
13:
927:10.1212/01.wnl.0000312375.79881.94
486:
14:
1839:
1623:Microangiopathic hemolytic anemia
1594:Mixed autoimmune hemolytic anemia
1139:
635:
622:deficiency. An advantage of the
227:) in the bone marrow and also by
1654:Hemolytic disease of the newborn
553:. A low level of blood Vitamin B
462:Inborn genetic mutations of the
112:
20:
1102:
724:(oval-shaped RBCs) are present.
590:methylmalonyl-coenzyme A mutase
313:juvenile megaloblastic anemia 1
1587:Paroxysmal cold hemoglobinuria
1067:
1042:
1008:
957:
905:
878:
806:
794:List of hematologic conditions
48:add the appropriate references
1:
1109:Hoffbrand, A. Victor (2012).
799:
1538:Southeast Asian ovalocytosis
1526:Minkowski–Chauffard syndrome
1088:10.1016/0002-9343(94)90149-X
891:. Elsevier Health Sciences.
536:
533:(extramedullary hemolysis).
7:
782:
669:mean corpuscular hemoglobin
531:reticulo-endothelial system
33:reliable medical references
10:
1844:
1647:Drug-induced nonautoimmune
1628:Thrombotic microangiopathy
1454:pyruvate kinase deficiency
385:abnormal folate metabolism
323:Ileal resection and bypass
229:hypersegmented neutrophils
1775:
1715:
1666:
1633:Hemolytic–uremic syndrome
1553:
1545:Hereditary stomatocytosis
1533:Hereditary elliptocytosis
1426:
1411:
1364:
1348:
1319:
1225:
1147:
743:lactic acid dehydrogenase
712:(abnormally shaped RBCs).
242:
155:
150:
141:
133:
128:
39:or relies too heavily on
1521:Hereditary spherocytosis
1726:Mean corpuscular volume
1690:Diamond–Blackfan anemia
1642:Drug-induced autoimmune
1577:Cold agglutinin disease
1383:Plummer–Vinson syndrome
1273:Rare Anemias Foundation
820:National Health Service
696:Neutrophil granulocytes
661:mean corpuscular volume
632:with intrinsic factor.
470:Di Guglielmo's syndrome
424:synthesis antagonists (
235:can be detected in the
1378:Iron-deficiency anemia
1050:"Megaloblastic Anemia"
1022:. 2012. Archived from
1016:"Megaloblastic Anemia"
298:Diphyllobothrium latum
257:-induced malabsorption
249:Vitamin B12 deficiency
199:vitamin B12 deficiency
62:"Megaloblastic anemia"
1697:Pure red cell aplasia
1464:hexokinase deficiency
692:count may be reduced.
491:There is a defect in
379:(indirect) Deficient
137:Megaloblastic anaemia
1702:Sideroblastic anemia
1510:Hemoglobin C disease
1396:Megaloblastic anemia
978:10.1038/ncpneuro1008
319:Chronic pancreatitis
170:Megaloblastic anemia
129:Megaloblastic anemia
1823:Nutritional anemias
1501:Sickle cell disease
1115:. In Longo, D. L.;
1026:on 30 November 2012
728:Howell-Jolly bodies
464:Methionine synthase
405:Synthesis Disorders
1788:Sulfhemoglobinemia
1226:External resources
754:methylmalonic acid
678:(MCHC, 32–36 g/dL)
570:methylmalonic acid
505:cell proliferation
408:Toxins and Drugs:
315:—and drug-induced)
1810:
1809:
1806:
1805:
1793:Reticulocytopenia
1783:Methemoglobinemia
1771:
1770:
1662:
1661:
1602:
1601:
1401:Pernicious anemia
1344:
1343:
1336:Polycythemia vera
1263:
1262:
760:
735:Blood chemistries
630:
620:
606:
596:
586:
576:
568:A measurement of
563:
557:
551:
545:
501:protein synthesis
480:Copper deficiency
369:and drug-induced)
348:Increased needs:
335:Folate deficiency
269:pernicious anemia
203:folate deficiency
174:macrocytic anemia
167:
166:
123:Medical condition
121:
120:
97:
1835:
1560:
1559:
1474:hemoglobinopathy
1424:
1423:
1362:
1361:
1353:
1352:
1324:
1323:
1302:
1295:
1288:
1279:
1278:
1145:
1144:
1133:
1132:
1130:
1128:
1114:
1106:
1100:
1099:
1071:
1065:
1064:
1062:
1060:
1046:
1040:
1039:
1033:
1031:
1012:
1006:
1005:
961:
955:
954:
909:
903:
902:
882:
876:
875:
873:
872:
863:. Archived from
857:
851:
850:
848:
847:
837:
831:
830:
828:
827:
810:
758:
737:will also show:
652:(RBC) count and
628:
618:
604:
594:
584:
574:
561:
555:
549:
543:
426:6-mercaptopurine
345:Deficient intake
265:intrinsic factor
260:Deficient intake
237:peripheral blood
146:
126:
125:
116:
115:
107:
104:
98:
96:
55:
24:
23:
16:
1843:
1842:
1838:
1837:
1836:
1834:
1833:
1832:
1828:Hematopathology
1813:
1812:
1811:
1802:
1767:
1711:
1670:
1658:
1598:
1549:
1415:
1407:
1340:
1315:
1313:red blood cells
1306:
1264:
1259:
1258:
1221:
1220:
1156:
1142:
1137:
1136:
1126:
1124:
1107:
1103:
1072:
1068:
1058:
1056:
1048:
1047:
1043:
1029:
1027:
1014:
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1009:
962:
958:
910:
906:
899:
883:
879:
870:
868:
859:
858:
854:
845:
843:
839:
838:
834:
825:
823:
812:
811:
807:
802:
785:
761:
638:
631:
621:
607:
597:
587:
577:
564:
558:
552:
546:
539:
489:
487:Pathophysiology
458:Erythroleukemia
397:Orotic aciduria
372:Intestinal and
300:(fish tapeworm)
279:Coeliac disease
245:
210:antimetabolites
197:, specifically
195:hypovitaminosis
124:
117:
113:
108:
102:
99:
56:
45:
41:primary sources
25:
21:
12:
11:
5:
1841:
1831:
1830:
1825:
1808:
1807:
1804:
1803:
1801:
1800:
1795:
1790:
1785:
1779:
1777:
1773:
1772:
1769:
1768:
1766:
1765:
1764:
1763:
1758:
1746:
1745:
1744:
1739:
1734:
1721:
1719:
1713:
1712:
1710:
1709:
1704:
1699:
1692:
1687:
1685:Fanconi anemia
1678:
1676:
1664:
1663:
1660:
1659:
1657:
1656:
1650:
1649:
1644:
1638:
1637:
1636:
1635:
1625:
1619:
1618:
1617:
1616:
1603:
1600:
1599:
1597:
1596:
1591:
1590:
1589:
1579:
1574:
1568:
1566:
1557:
1551:
1550:
1548:
1547:
1542:
1541:
1540:
1530:
1529:
1528:
1512:
1507:
1498:
1497:
1496:
1491:
1486:
1469:
1468:
1467:
1466:
1461:
1456:
1444:
1432:
1430:
1421:
1409:
1408:
1406:
1405:
1404:
1403:
1388:
1387:
1386:
1385:
1370:
1368:
1359:
1350:
1346:
1345:
1342:
1341:
1339:
1338:
1332:
1330:
1321:
1317:
1316:
1305:
1304:
1297:
1290:
1282:
1276:
1275:
1270:
1261:
1260:
1257:
1256:
1242:
1230:
1229:
1227:
1223:
1222:
1219:
1218:
1207:
1196:
1181:
1157:
1152:
1151:
1149:
1148:Classification
1141:
1140:External links
1138:
1135:
1134:
1101:
1066:
1041:
1007:
972:(2): 106–111.
956:
921:(9): 639–643.
904:
897:
877:
852:
832:
804:
803:
801:
798:
797:
796:
791:
784:
781:
767:
766:
763:
757:
746:
732:
731:
725:
719:
713:
710:poikilocytosis
703:
700:multisegmented
693:
686:
679:
672:
663:(MCV, >100
657:
650:red blood cell
637:
636:Blood findings
634:
627:
624:Schilling test
617:
614:Schilling test
610:Schilling test
603:
593:
583:
573:
560:
554:
548:
542:
538:
535:
520:intramedullary
488:
485:
484:
483:
477:
472:
467:
460:
455:
454:
453:
448:
443:
433:
419:
406:
399:
393:
390:
389:
388:
377:
370:
360:
346:
343:
332:
331:
330:
324:
321:
316:
302:
285:diverticulosis
281:
276:
261:
258:
244:
241:
182:red blood cell
165:
164:
159:
153:
152:
148:
147:
139:
138:
135:
131:
130:
122:
119:
118:
111:
109:
103:September 2018
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26:
19:
9:
6:
4:
3:
2:
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1774:
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1738:
1735:
1733:
1730:
1729:
1728:
1727:
1723:
1722:
1720:
1718:
1714:
1708:
1707:Myelophthisic
1705:
1703:
1700:
1698:
1694:
1693:
1691:
1688:
1686:
1682:
1679:
1677:
1674:
1669:
1665:
1655:
1652:
1651:
1648:
1645:
1643:
1640:
1639:
1634:
1631:
1630:
1629:
1626:
1624:
1621:
1620:
1615:
1612:
1611:
1610:
1609:
1605:
1604:
1595:
1592:
1588:
1585:
1584:
1583:
1580:
1578:
1575:
1573:
1570:
1569:
1567:
1565:
1561:
1558:
1556:
1552:
1546:
1543:
1539:
1536:
1535:
1534:
1531:
1527:
1524:
1523:
1522:
1519:
1517:
1513:
1511:
1508:
1506:
1502:
1499:
1495:
1492:
1490:
1487:
1485:
1482:
1481:
1480:
1477:
1475:
1471:
1470:
1465:
1462:
1460:
1457:
1455:
1452:
1451:
1450:
1449:
1445:
1443:
1440:
1438:
1434:
1433:
1431:
1429:
1425:
1422:
1419:
1414:
1410:
1402:
1399:
1398:
1397:
1393:
1390:
1389:
1384:
1381:
1380:
1379:
1375:
1372:
1371:
1369:
1367:
1363:
1360:
1358:
1354:
1351:
1347:
1337:
1334:
1333:
1331:
1329:
1325:
1322:
1318:
1314:
1310:
1303:
1298:
1296:
1291:
1289:
1284:
1283:
1280:
1274:
1271:
1269:
1266:
1265:
1255:
1252:
1248:
1247:
1243:
1241:
1237:
1236:
1232:
1231:
1228:
1224:
1217:
1213:
1212:
1208:
1206:
1202:
1201:
1197:
1195:
1191:
1190:
1186:
1182:
1180:
1176:
1172:
1168:
1167:
1163:
1159:
1158:
1155:
1150:
1146:
1122:
1118:
1113:
1105:
1097:
1093:
1089:
1085:
1082:(3): 239–46.
1081:
1077:
1070:
1055:
1051:
1045:
1038:
1025:
1021:
1017:
1011:
1003:
999:
995:
991:
987:
983:
979:
975:
971:
967:
960:
952:
948:
944:
940:
936:
932:
928:
924:
920:
916:
908:
900:
898:9780702069253
894:
890:
889:
881:
867:on 2008-03-23
866:
862:
856:
842:
836:
822:
821:
815:
809:
805:
795:
792:
790:
787:
786:
780:
778:
774:
770:
764:
755:
751:
747:
744:
741:An increased
740:
739:
738:
736:
729:
726:
723:
720:
717:
714:
711:
707:
704:
701:
697:
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509:cell division
507:and impaired
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451:Nitrous Oxide
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438:antagonists (
437:
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414:antagonists (
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363:Malabsorption
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327:Nitrous oxide
325:
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309:malabsorption
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64: –
63:
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58:Find sources:
53:
49:
43:
42:
38:
34:
29:This article
27:
18:
17:
1756:normochromic
1748:
1724:
1606:
1514:
1472:
1446:
1435:
1395:
1328:Polycythemia
1244:
1233:
1209:
1198:
1183:
1160:
1125:. Retrieved
1120:
1117:Fauci, A. S.
1104:
1079:
1075:
1069:
1057:. Retrieved
1053:
1044:
1035:
1028:. Retrieved
1024:the original
1019:
1010:
969:
965:
959:
918:
914:
907:
887:
880:
869:. Retrieved
865:the original
855:
844:. Retrieved
835:
824:. Retrieved
817:
808:
771:
768:
756:in Vitamin B
750:homocysteine
733:
706:Anisocytosis
683:reticulocyte
639:
601:
567:
540:
513:
490:
430:azathioprine
416:methotrexate
311:(congenital—
296:
255:Achlorhydria
225:megaloblasts
222:
218:trimethoprim
214:azathioprine
207:
169:
168:
100:
90:
83:
76:
69:
57:
37:verification
30:
1761:hypochromic
1717:Blood tests
1479:Thalassemia
1437:enzymopathy
1366:Nutritional
1235:MedlinePlus
1127:October 23,
1020:MedlinePlus
777:hyperplasia
773:Bone marrow
592:. Vitamin B
516:bone marrow
306:vitamin B12
293:anastomosis
273:gastrectomy
233:neutrophils
134:Other names
31:needs more
1817:Categories
1742:macrocytic
1737:microcytic
1732:normocytic
1695:Acquired:
1681:Hereditary
1448:glycolysis
1428:Hereditary
1211:DiseasesDB
1076:Am. J. Med
871:2008-03-12
846:2009-02-07
826:2021-05-09
800:References
762:deficiency
748:Increased
722:Ovalocytes
716:Macrocytes
681:Decreased
659:Increased
654:hemoglobin
648:Decreased
642:blood film
527:macrocytes
440:cytarabine
436:Pyrimidine
412:Folic acid
401:Inherited
367:congenital
341:Alcoholism
304:Selective
263:Deficient
190:cell cycle
162:Hematology
73:newspapers
1413:Hemolytic
1246:eMedicine
1059:10 August
986:1745-8358
935:1526-632X
915:Neurology
698:may show
580:cobalamin
537:Diagnosis
523:hemolysis
446:Phenytoin
376:resection
358:cirrhosis
350:pregnancy
157:Specialty
1671:(mostly
1668:Aplastic
1608:membrane
1555:Acquired
1516:membrane
1416:(mostly
1309:Diseases
1254:ped/2575
1251:med/1420
1037:tissues.
1002:27892441
994:19194390
951:19614652
943:18525032
783:See also
690:platelet
381:thiamine
1205:D000749
1096:8154512
1030:21 June
674:Normal
514:In the
374:jejunal
289:fistula
193:due to
87:scholar
52:removed
1673:normo-
1418:normo-
1392:Macro-
1374:Micro-
1357:Anemia
1240:000567
1094:
1000:
992:
984:
949:
941:
933:
895:
667:) and
656:levels
608:, the
422:Purine
354:infant
243:Causes
178:anemia
89:
82:
75:
68:
60:
1776:Other
1505:trait
1494:delta
1484:alpha
1216:29507
1179:D53.1
1175:D52.0
1171:D51.1
998:S2CID
947:S2CID
671:(MCH)
180:is a
176:. An
94:JSTOR
80:books
1564:AIHA
1489:beta
1200:MeSH
1189:9-CM
1129:2015
1092:PMID
1061:2021
1032:2015
990:PMID
982:ISSN
939:PMID
931:ISSN
893:ISBN
752:and
688:The
640:The
499:and
466:gene
66:news
35:for
1311:of
1194:281
1185:ICD
1162:ICD
1084:doi
974:doi
923:doi
818:UK
497:RNA
403:DNA
271:or
220:).
216:or
201:or
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