A 64 years old man, having Mittal stenosis and AF with embolism in leg, treated by embolectomy ten years ago, on Acenocoumarol, digoxin, Diuretic c/o pain and swelling in both first metatarso-phalangeal joints. Pictures posted. He does a lot of writing work.
His S.B12 level is 98 mcg only. Kindly diagnose this problem and advice treatment.
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