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[] CONCLUSION We have described two rare cases of IAS, and it is important to consider IAS in the differential diagnosis of evaluation of hypoglycemia to avoid unnecessary investigations and surgical interventions

Homocysteine is an intermediate product of methionine metabolism and is metabolized by two pathways: the remethylation pathway, which regenerates methionine, and the transsulfuration pathway, which degrades homocysteine into cysteine and then taurine

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Therefore, the simultaneous targeting of both aspects of this feedback loop presents a novel therapeutic strategy with potential for the treatment of CKD (Table I)