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injectables may reach higher local concentrations but lack extensive human trial data and FDA approval for this purpose

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However, some may experience side effects

Only about 17% of patients under 10 years of age are found to have neuropsychiatric symptoms at presentation, whereas in patients presenting after 18 years of age, 74% experience neurologic manifestations.2,20 It is usually after 10 years of age that patients may manifest evidence of involvement of the other organ systems such as renal, hematologic, and endocrine (Figure 252)

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