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Haematological symptoms often appear first and include: Fatigue and weakness due to anaemia Pallor (pale skin) Shortness of breath, particularly on exertion Heart palpitations Glossitis (sore, red tongue) Mouth ulcers Neurological manifestations can be particularly concerning and may include: Paraesthesia (pins and needles) in hands and feet Peripheral neuropathy causing numbness or altered sensation Difficulty walking or balance problems (ataxia) Memory problems and cognitive difficulties Mood changes, including depression or irritability Rare optic neuropathy in severe cases Other symptoms that may occur include: Digestive disturbances Loss of appetite and weight loss Generalised weakness It is crucial to note that neurological symptoms can occur even in the absence of anaemia, and you should contact your GP urgently if you experience persistent paraesthesia, balance problems, memory difficulties, or unexplained neurological symptoms

Neuron 81 , 13 (2014)

Zundel, W

On the other hand, activation of MAPK improves the expression of AP-1 signaling molecules and increases the production of iNOS, the uninhibited source of NO

The underlying pathogenesis is due to an allergic cutaneous manifestation resulting from an exaggerated immune response to external stimuli