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Los efectos secundarios comunes incluyen, pero pueden no estar limitados a: dolor o enrojecimiento en el sitio de inyeccin diarrea leve prurito (picazn) hinchazn aumentada dolor en las articulaciones mareo dolor de cabeza nerviosismo o ansiedad Efectos secundarios graves pueden incluir: reacciones alrgicas trombosis vascular perifrica hipokalemia (bajos niveles de potasio) edema pulmonar (acumulacin de lquido alrededor o en los pulmones) trombocitosis insuficiencia cardaca congestiva Se han reportado casos de shock anafilctico y muerte tras la administracin parenteral de vitamina B12

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This would include the following: Blood: Electrolytes, glucose, blood urea nitrogen, creatinine, amino acids, alanine aminotransferase, gamma glutamyltransferase, lactate, ammonia, plasma carnitine and acylcarnitine, amylase and lipase Urine for D-aminolevulinic acid, organic acids, ketones and porphilinogen to rule out metabolic disorders Imaging to include: upper gastrointestinal (GI) radiographic imaging, abdominal ultrasound or computed tomography scan to exclude structural or inflammatory disorders of the GI tract Brain magnetic resonance imaging, upper GI endoscopy and urine toxicology may be warranted in certain situations MANAGEMENT (Fig