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Das Arzneimittel darf nicht angewendet werden, wenn Sie überempfindlich (allergisch) gegen Cyanocobalamin oder einen der sonstigen Bestandteile des Präparates sind

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It is, therefore, possible that in some patients with PIMD, there are some pre-existing genetic risk factors (“first hit”), and certain peripheral trauma reduced the threshold of manifestation of PIMD (“second hit”)