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10.1016/j.ecoenv.2020.111696 33 ChangX.ZhuA.LiuF.ZouL.SuL.LiS.et al (2017)

Damaged mitochondria produce excessive reactive oxygen species, which can trigger mast cell degranulation independently of IgE

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We order vitamin B12 and folate testing when a person with Down syndrome we are evaluating has symptoms described above, has a lab abnormality for which follow up testing of vitamin B12 and/or folate is indicated, or the person has a condition in which deficiency is common (e.g., celiac disease)