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By using an electrophoretic pattern to screen pathognomonic RBC shape, HbS may be identified from other hemoglobins

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While there is some limited evidence of the efficacy of 1,000 micrograms daily dosing of oral cyanocobalamin, this is mainly based on the correction of serum vitamin B12 levels, rather than any impact on clinical signs and symptoms[24]

High-risk patients including those on long-term or high-dose metformin, older adults, and those with additional risk factors should be considered for periodic B12 monitoring