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The possible mechanisms for the generation of acanthocytes include abnormal phospholipid metabolism and an increased ratio of cholesterol to phosphatidylcholine in the cell membrane, both of which can cause abnormalities in the erythrocyte membrane ( In HAPC rats, an increase in EOF was observed, accompanied by decreased resistance of cells to hemolysis in hypotonic solutions

Ishikawa M, Tsukimi Y, Ogawa T, et al

Treatment with intranasal cyanocobalamin should be delayed until symptoms resolve in patients with nasal congestion, allergic rhinitis, and upper respiratory infection