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CRS is characterized by fulminant activation of a large number of lymphocytes that release inflammatory cytokines and result in severe tissue damage with multi-organ dysfunction syndrome (MODS) 97

Fang X, Wang H, Han D, Xie E, Yang X, Wei J, et al

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Side effects from B12 supplementation are uncommon but may include: Mild gastrointestinal symptoms such as nausea or diarrhoea, typically with very high oral doses Headache or dizziness in some individuals Skin reactions (rash, itching) at injection sites when using intramuscular preparations Rare but serious allergic reactions, including anaphylaxis with injectable forms Hypokalaemia (low potassium) may occur during rapid correction of severe megaloblastic anaemia If you experience symptoms of a severe allergic reaction (difficulty breathing, severe rash, swelling of face or throat) after taking B12, seek immediate medical attention

Oncology (Williston Park) 2010;24:201