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In rare inborn errors such as cblC ( MMACHC ), cblA/cblB ( MMAA / MMAB ), and CD320 defects, the specific genetic lesion determines both whether B12 helps and which form (often hydroxocobalamin, given parenterally) is preferred
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Tissue Anesthetized A local anesthetic (typically lidocaine) is used to numb the skin and the tissues along the anticipated path of the needle
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