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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)

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According to the Linus Pauling Institute at Oregon State University, pernicious anemia and B12 malabsorption are associated with a chronic inflammatory disease in the stomach, referred to as atrophic gastritis (low stomach acid)