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On this current presentation, he was admitted to the neurology department, with an exam significant for bilateral hand paresthesias, weakness in bilateral lower extremities with increased tone and decreased proprioception, and labs significant for hemoglobin of 10.2 g/dL with MCV of 75.4 fl, vitamin B12 level of 177 pg/mL (low), MMA of 172 nmol/L (normal), without evidence for intrinsic factor blocking antibody, ruling out pernicious anemia