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It may be that a discussion is needed to explore other potential causes for the symptoms or to re-evaluate the patients current treatment plan, but an early injection might not be the standard solution

Cobalamin C defect should be considered in the differential diagnosis in adult patients with atypical hemolytic uremic syndromes, slow unexplained decline in renal function, idiopathic neuropathies, spinal cord degenerations, ataxias, unexplained or recurrent thrombosis, visual field defects, maculopathy, and optic disc atrophy (120)

Complete symptom resolution, particularly for neurological complications, can take 318 months of regular treatment depending on deficiency severity

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