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Although there is a broad clinical spectrum of glutathione synthetase deficiency, manifestations usually include hemolytic anemia, often include metabolic acidosis, and sometimes include progressive neurologic symptoms as well as other systemic signs (eg, respiratory distress, sepsis, hyperbilirubinemia) (62
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Normal digestion typically prevents significant gas accumulation, but when digestive processes are disrupted, sulfur-containing compounds remain in the gastrointestinal tract longer, allowing more bacterial fermentation to occur
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