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Description
Clinical symptoms result from binding of IgM to red cells in vascular beds where the temperature may fall below 30C, such as in exposed fingers, toes, and ears

This activation triggers the release of cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-), which further damage neurons (Zhang and Hlscher 2020)
In Figure 7C we show an estimate of liver damage done by these chronic doses

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