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Decreased placental 11-HSD2 expression and activity were not due to mutations or imprinting (281) but are proposed to be mediated by promoter hypermethylation (282)

The risk increases in patients with MTHFR gene variants (which impair methylation efficiency) or those already consuming high-dose methionine supplements

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While serious toxicity is infrequently reported, a notable proportion of patients, approximately one-third, may exhibit intolerance, necessitating discontinuation of probenecid

Other medical conditions or treatments cause secondary hemochromatosis