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It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances (Green et al., 2017)

Inflammation, hypercoagulability, microvascular thrombosis, endothelial dysfunction, and mitochondrial dysfunction can induce acute kidney injury (AKI), which could further develop into chronic kidney disease (CKD) under chronic inflammation and cytokine storm (Rai, 2023)