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The mechanisms proposed include upregulation of growth hormone receptor expression, modulation of the nitric oxide (NO) system, and interaction with the dopaminergic and GABAergic pathways 2

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In families of patients with PA (pernicious anaemia), ulcerative colitis, rheumatoid arthritis, polymyalgia, psoriasis, sarcoidosis, lupus were in one study more common than in those of people without PA