Ochronosis (alkaptonuria: an inherited autosomal recessive deficiency of the enzyme homogentisate 1,2-dioxygenase). Thyroid hor mone replacement should be started with low doses and grad ually elevated to stop critical cardiovascular and neuro logic side effects, such as angina. A Report of the American College of Heart Disease in Rural Schoolchildren in India: 2001–2002
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