doi:10.1155/2015/648108 Pickart L, Vasquez-Soltero JM, Margolina A
Acknowledgements PSA is supported by the American College of Medical Genetics Foundation/Genzyme 2014-2015 Fellowship in Biochemical Genetics
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)
While symptoms can be episodic, the ongoing irritation, inflammation, and back pressure from the mechanical obstructions can result in cumulative, irreversible damage to the meibomian glands, the eyelids, and the surface of the eyes
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