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The patients chronic, nonspecific symptomsincluding fatigue, musculoskeletal pain, paresthesia, cognitive disturbances, and optic neuritiswere misattributed to multiple conditions for nearly a decade, with the absence of classic hematologic findings further complicating the diagnosis

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The practical consequence is that once a vial is opened and the rubber stopper has been pierced with a needle, the preservative keeps the contents safe to use for up to 28 days, provided the vial is stored correctly and the stopper is wiped with an alcohol prep pad before each draw