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Common reasons include low glutathione concentration, unstable liposomes, tablet compression destroying liposomal structure, and sub-therapeutic dosing

If chronic disease is the documented cause (rheumatoid arthritis, chronic infection, inflammatory bowel disease), D63.8 applies

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This study together with El-Mir et al

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Wu YT, Ru ZQ, Peng Y, Fu Z, Jia QY, Kang ZJ