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However, it is noteworthy that some studies suggest biopsy procedures may potentially exacerbate the condition, rarely leading to respiratory failure (9)

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10.1073/pnas.0405596101 Proc

The trial included 60 adult participants (mean age approximately 49) who had clinical follow-up with labs every 2 months for up to 2 years, with some withdrawing early due to spontaneous remission, indication for definitive therapy (e.g., thyroidectomy or radioiodine), or an intolerance to the treatment