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One reported case involved a 22-year-old with a B12 level of 180 pg/mL, progressive stiffness and tingling, and MRI showing abnormal signal in the brain and the posterior spinal cord

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In addition, CS directly affects the epithelial cells and results in increased permeability, mucus overproduction, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of neutrophils, and disturbed lymphocyte balance toward T helper type 2 (Th2) cells (Strzelak et al., 2018)