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A telehealth relationship should still involve real clinical review, a way to reach someone when something changes, and a clear plan for lab work

Hendrickse RG, Coulter JB, Lamplugh SM et al (1982) Aflatoxins and kwashiorkor: a study in Sudanese children

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It is believed to involve an unknown stimulus that leads to the activation of lymphocytes through a delayed- type hypersensitivity reaction, ultimately initiating a proinflammatory cascade and granuloma formation (98)