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BM biopsy revealed hypercellular marrow with erythroid hyperplasia and no significant dysplasia or increase in blasts along with a DNMT3A missense mutation of unknown significance on myelodysplastic syndrome panel testing

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[1] [2] Following sleeve gastrectomy, the substantial reduction in stomach volume means fewer parietal cells are available, leading to a reduction in intrinsic factor production though the degree varies between individuals and intrinsic factor production does not cease entirely