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If the patient is suspected to be sensitive to cobalt or other components of cobalamin, an intradermal test dose is recommended.[12][15] Several laboratory tests should be performed prior to treatment with cyanocobalamin, including serum vitamin B12, folate, iron, hematocrit, and reticulocyte count

pSS was diagnosed according to the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria (24)