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However, the reticular production index (RPI) shows an increase of 4.8% which is untypical in PTMA, as the shortage of resources for DNA synthesis should impair the hematopoiesis in bone marrow, causing uncompensated blood loss replacement presented by a low RPI [2]

Feeding and swallowing difficulties, which may require the insertion of a gastrostomy/feeding tube for adequate nutrition and to protect the airway from aspiration of milk/food/secretions