# Why Is My Cat sneezing with blood? Upper Respiratory Infection and Nasal Polyps


## Key Takeaways

-   Sneezing with blood (epistaxis) in cats is a sign of significant nasal irritation or tissue damage, most commonly caused by chronic upper respiratory infections (URIs) or nasal polyps.
-   URIs, often viral (e.g., FHV-1, FCV) or bacterial, cause inflammation and epithelial damage, leading to fragile nasal mucosa prone to bleeding during sneezing; treatment focuses on supportive care and antibiotics for secondary infections.
-   Nasal polyps are benign, inflammatory growths that can cause more frequent and significant bleeding due to their vascular nature and potential for trauma during sneezing; surgical removal is the primary treatment.
-   Emergency situations requiring immediate veterinary attention include continuous or heavy bleeding, open-mouth breathing, lethargy, pale gums, or facial swelling, which may indicate more serious conditions like tumors or coagulopathies.
-   Diagnostic workup for bloody sneezes may include physical examination, blood tests, viral testing (PCR), radiography, rhinoscopy, and CT scans, with biopsies essential for definitive diagnosis of masses.
-   Prevention strategies include core vaccinations against FHV-1 and FCV, stress reduction, good hygiene in multi-cat environments, and regular veterinary check-ups to address dental disease or early nasal issues.

---

**Direct answer:** A [cat](/knowledge/veterinary-medicine/clinical-methods/cat) sneezing with blood (epistaxis) is a sign of significant nasal irritation or tissue damage. The two most common underlying causes are chronic upper respiratory infections (URIs), often viral or bacterial, and nasal polyps, which are non-cancerous growths in the nasal passages. While a single drop of blood might follow a violent sneeze, recurrent or heavy bleeding requires immediate veterinary attention to rule out more serious conditions like tumors, foreign bodies, or clotting disorders.

**Triage summary for owners:** If your cat has a single episode of a small blood spot and is otherwise eating, playing, and breathing normally, monitor closely for 24 hours. However, if the bleeding is continuous, if your cat is open-mouth breathing, lethargic, pale, or has dark, coffee-ground-like blood from the nose or mouth, treat this as an emergency. Do not attempt to stop the bleeding by packing the nose; instead, keep your cat calm and contact your veterinarian or an emergency clinic immediately.

## At a Glance: URI vs. Nasal Polyps

This table compares the typical features of the two primary causes discussed in this article. It is a guide, not a diagnosis. Only a veterinarian can confirm the underlying issue.

| Feature | Upper Respiratory Infection (URI) | Nasal Polyps |
| :--- | :--- | :--- |
| **Primary Cause** | Viral (e.g., feline herpesvirus, calicivirus) or bacterial infection [<a href="#ref-1">1</a>, <a href="#ref-2">2</a>] | Non-cancerous, inflammatory growths in the nasal passages [<a href="#ref-1">1</a>, <a href="#ref-3">3</a>] |
| **Typical Age** | Any age, but more common in kittens and young cats | Often younger cats (under 2 years), but can occur at any age |
| **Key Symptoms** | Sneezing, nasal discharge (clear to pus-like), eye discharge, fever, lethargy, reduced appetite | Progressive nasal congestion, noisy breathing (stertor), sneezing, nasal discharge, sometimes visible mass at the nostril |
| **Blood in Sneeze** | Occasional, usually due to severe inflammation and irritation of the nasal lining | More frequent, as the polyp itself is fragile and bleeds easily |
| **Progression** | Often acute, may resolve in 1-3 weeks, but can become chronic | Chronic and progressive, with symptoms worsening over time |
| **Treatment** | Supportive care, antibiotics for secondary bacterial infections, antivirals, and immune support [<a href="#ref-1">1</a>, <a href="#ref-4">4</a>] | Surgical removal is the primary treatment [<a href="#ref-5">5</a>, <a href="#ref-6">6</a>] |
| **Prognosis** | Good with supportive care, but may become a chronic carrier | Good after successful surgical removal, though recurrence is possible [<a href="#ref-6">6</a>] |

## Understanding the Feline Upper Respiratory Tract

To understand why blood appears, it helps to know the anatomy. The feline nasal cavity is a complex structure lined with a delicate, highly vascular mucous membrane (the nasal mucosa). This lining is rich in blood vessels that help warm and humidify inhaled air. The nasal cavity is divided into two halves by the nasal septum and contains intricate bony shelves called turbinates, which increase the surface area for this process.

The pharynx sits behind the nasal cavity and oral cavity, serving as a common passageway for air and food. In cats, the opening from the nasal cavity to the pharynx is the choana. Nasal polyps often originate in the middle ear or the eustachian tube and can extend down into the pharynx or up into the nasal cavity.

When the nasal mucosa becomes inflamed, its blood vessels dilate and become fragile. Sneezing is a forceful, reflexive expulsion of air meant to clear irritants. The sheer force of a sneeze, combined with inflamed and fragile blood vessels, can easily cause a small vessel to rupture, leading to blood-tinged discharge.

## Primary Cause 1: Upper Respiratory Infections (URIs)

[Feline upper respiratory infections](/knowledge/bacteria/pet-bacteria/feline-upper-respiratory-infections-herpesvirus-calicivirus-bordetella) are extremely common and are a leading cause of sneezing and nasal inflammation. They are highly contagious and spread through direct contact, aerosolized droplets from sneezes, and contaminated objects (fomites).

### Viral and Bacterial Pathogens
The most common pathogens are viruses, particularly feline herpesvirus type 1 (FHV-1) and [feline calicivirus](/knowledge/viruses/pet-viruses/feline-calicivirus) (FCV). These viruses damage the epithelial lining of the nasal passages, causing severe inflammation and ulceration. This damage directly compromises the integrity of the nasal mucosa, making it more prone to bleeding.

Secondary bacterial infections are also a major concern. *[Bordetella bronchiseptica](/knowledge/bacteria/pet-bacteria/bordetella-bronchiseptica)* and *Chlamydia felis* are primary bacterial pathogens, but often, bacteria like *Pasteurella* and *Staphylococcus* take advantage of the damaged tissue. This is analogous to the mixed inflammatory profiles seen in chronic human rhinosinusitis, where bacterial colonization and biofilm formation complicate viral or allergic inflammation [<a href="#ref-7">7</a>]. While the specific pathogens differ, the principle of a damaged mucosal barrier leading to a polymicrobial environment holds true. The inflammation can become chronic, leading to persistent sneezing and intermittent blood-tinged discharge.

### Why URIs Cause Bleeding
The mechanism is straightforward. The viral or bacterial infection triggers a robust inflammatory response. This response causes:
1.  **Vasodilation:** Blood vessels in the nose widen, bringing more blood to the area to fight the infection.
2.  **Mucosal Edema:** The nasal lining becomes swollen and boggy.
3.  **Epithelial Damage:** The surface cells are destroyed, exposing the underlying, fragile blood vessels.
4.  **Sneezing:** The inflammation triggers the sneeze reflex. The mechanical force of the sneeze, applied to already damaged and fragile vessels, causes them to rupture.

The blood is usually bright red and mixed with mucus. The amount is typically small, appearing as streaks or a few drops. However, in severe or chronic cases, the bleeding can be more pronounced.

## Primary Cause 2: Nasal Polyps

Nasal polyps are non-cancerous, smooth, round growths that arise from the mucous membrane of the nasal cavity or the lining of the middle ear (via the eustachian tube). They are a significant cause of chronic nasal disease in cats, particularly younger cats.

### Pathophysiology of Polyps
In human medicine, chronic rhinosinusitis with nasal polyps (CRSwNP) is understood as a complex inflammatory disease driven by dysregulated immune responses, often involving type 2 inflammation [<a href="#ref-1">1</a>, <a href="#ref-8">8</a>]. While the exact cause of polyps in cats is not fully understood, they are considered to be the result of chronic inflammation. The body's attempt to heal the inflamed tissue can lead to the growth of a polyp. Research in human medicine has identified that persistent inflammation, driven by immune cells like eosinophils and specific T-helper cells, leads to tissue remodeling and the formation of polyps [<a href="#ref-3">3</a>, <a href="#ref-8">8</a>, <a href="#ref-9">9</a>]. It is reasonable to hypothesize that a similar chronic inflammatory process, possibly triggered by a URI, contributes to polyp formation in cats.

### How Polyps Cause Bleeding
A polyp is a growth of tissue on a stalk. It is covered by the same fragile, inflamed mucous membrane as the rest of the nasal cavity. Because the polyp is an abnormal growth, its blood supply can be somewhat disorganized and fragile. The polyp itself can easily become traumatized, especially during a sneeze. The bleeding is often more frequent and can be more significant than with a simple URI because the polyp is a discrete, vascular mass. As the polyp grows, it can also cause physical obstruction, leading to increased pressure and further inflammation in the nasal passages.

### Symptoms Beyond Bleeding
Cats with nasal polyps often exhibit a gradual onset of symptoms, including:
- **Noisy breathing:** A snoring or rattling sound, especially when inhaling (stertor).
- **Nasal discharge:** Often thick and mucoid, which may be clear, yellow, or blood-tinged.
- **Sneezing:** Often more persistent than with a simple URI.
- **Visible mass:** In some cases, the polyp may extend out of the nostril or down into the throat, where it can be seen.
- **Changes in voice:** A change in the sound of their meow, often becoming hoarse.
- **Head shaking or pawing at the face:** Signs of nasal discomfort.

## Other Potential Causes of Bloody Sneezes

While URIs and polyps are the primary focus, it is critical for owners to understand that other, more serious conditions can cause a cat to sneeze blood. A veterinarian must rule these out.

* **Nasal Foreign Bodies:** A grass awn, seed, or small object can become lodged in the nasal passage, causing intense irritation, sneezing, and bleeding.
* **Nasal Tumors:** Cancerous growths (e.g., adenocarcinoma, lymphoma) are a serious concern, especially in older cats. They are invasive and destructive, causing significant bleeding and facial deformity in advanced cases.
* **Dental Disease:** Severe dental infections, particularly of the tooth roots in the upper jaw, can erode into the nasal cavity, causing inflammation and bleeding.
* **Trauma:** A fall or a blow to the head can cause direct injury to the nasal passages.
* **Coagulopathies (Bleeding Disorders):** Conditions that prevent the blood from clotting properly, such as rodenticide (rat poison) toxicity, severe liver disease, or immune-mediated thrombocytopenia, can lead to spontaneous bleeding from the nose and other sites.
* **Fungal Infections:** Cryptococcosis, a fungal infection, can cause chronic, destructive nasal disease in cats, leading to sneezing, discharge, and bleeding.

## Risk Factors for Sneezing with Blood

Several factors can increase a cat's risk of developing the underlying causes of bloody sneezes.

| Risk Factor | Association with URI | Association with Polyps |
| :--- | :--- | :--- |
| **Age** | Kittens and young cats are more susceptible to severe URIs due to their immature immune systems. | Polyps are most commonly diagnosed in cats under two years of age. |
| **Environment** | Cats in multi-cat households, shelters, or catteries have a higher risk of exposure to infectious agents. | Chronic inflammation from any source may predispose a cat to polyp formation. |
| **Stress** | Stress can trigger a recurrence of latent feline herpesvirus, leading to a flare-up of URI symptoms. | Not a direct risk factor. |
| **Breed** | Brachycephalic breeds (flat-faced, like Persians) may have anatomical predispositions to more severe nasal disease. | No specific breed predilection is widely recognized. |
| **Chronic Disease** | Immunosuppressive diseases like [Feline Leukemia Virus](/knowledge/viruses/pet-viruses/feline-leukemia-virus) (FeLV) or [Feline Immunodeficiency Virus](/knowledge/viruses/pet-viruses/feline-immunodeficiency-virus) (FIV) increase susceptibility to chronic infections. | Chronic, untreated nasal inflammation is a suspected precursor. |

## Veterinary Examination and Diagnostics

If you bring your cat to the veterinarian for sneezing with blood, they will perform a thorough workup. The goal is to identify the underlying cause and rule out life-threatening conditions.

### Initial Physical Examination
The veterinarian will start with a complete physical exam, including:
- **Vital signs:** Temperature, heart rate, respiratory rate.
- **Oral examination:** To check for dental disease, masses on the palate, or polyps extending into the throat.
- **Nasal examination:** Looking for discharge, asymmetry, or visible masses.
- **Auscultation:** Listening to the lungs and trachea to assess for lower respiratory involvement.
- **Evaluation of the eyes:** Checking for discharge, third eyelid protrusion, or ulcers, which are common with FHV-1.

### Advanced Diagnostics
To get a definitive diagnosis, more advanced tests are often needed.

1.  **Blood Tests (CBC/Chemistry):** These can reveal signs of infection (elevated white blood cells), inflammation, or underlying organ disease. They are also essential for assessing clotting function and ruling out systemic diseases.
2.  **Viral Testing:** Swabs from the mouth, eyes, or nose can be tested via PCR to confirm the presence of FHV-1 or FCV.
3.  **Radiographs (X-rays):** Dental X-rays can identify tooth root abscesses. Skull X-rays may show fluid, masses, or bone destruction within the nasal cavity, although they are less detailed than advanced imaging.
4.  **Rhinoscopy:** This is a key procedure. A rigid or flexible camera is inserted into the nasal passages under general anesthesia. It allows the veterinarian to directly visualize the nasal lining, identify polyps, foreign bodies, or tumors, and take biopsies.
5.  **Computed Tomography (CT Scan):** A CT scan is the gold standard for imaging the nasal cavity. It provides a detailed, three-dimensional view of the bones and soft tissues, which is invaluable for identifying the extent of masses, bone lysis (destruction), and foreign bodies. This is particularly important for surgical planning [<a href="#ref-5">5</a>, <a href="#ref-6">6</a>].
6.  **Biopsy:** If a mass is seen on imaging or rhinoscopy, a small tissue sample (biopsy) will be taken and sent to a pathologist for analysis. This is the only way to definitively diagnose a tumor and distinguish it from a benign polyp.

## Evidence-Based Management and Treatment

Treatment depends entirely on the underlying cause.

### Management of Upper Respiratory Infections
There is no cure for viral URIs, so treatment is focused on supportive care and managing secondary infections.

- **Supportive Care:** This is the cornerstone of therapy. It includes ensuring the cat is eating and drinking, providing steam therapy (e.g., in a steamy bathroom) to help loosen nasal discharge, and gently cleaning the nose and eyes.
- **Antibiotics:** While ineffective against viruses, antibiotics are often prescribed to treat or prevent secondary bacterial infections. The choice of antibiotic should ideally be based on culture and sensitivity testing, especially in chronic cases [<a href="#ref-7">7</a>].
- **Antiviral Medications:** Drugs like famciclovir are available for feline herpesvirus. They can help reduce the severity and duration of clinical signs in some cats.
- **Immune Support:** L-lysine is a supplement sometimes used to help manage FHV-1, though its efficacy is debated. Your veterinarian can advise on the best course.
- **Nasal Flush:** In cases of chronic, severe rhinitis, a veterinarian may perform a nasal flush under anesthesia to remove thick, infected debris from the nasal passages.

### Management of Nasal Polyps
The definitive treatment for a nasal polyp is surgical removal.

- **Traction-Avulsion:** In many cases, a polyp can be grasped with forceps and gently pulled out. This is often done under anesthesia, sometimes guided by rhinoscopy. This is a minimally invasive approach.
- **Surgical Excision (Bullae Osteotomy):** If the polyp originates from the middle ear, a more involved surgery called a ventral bullae osteotomy (VBO) may be required. This involves opening the bony chamber of the middle ear to remove the polyp and its root, which significantly reduces the chance of recurrence.
- **Post-Operative Care:** After surgery, cats may need anti-inflammatory medications to reduce swelling and pain medication. They should be monitored for recurrence of symptoms. The recurrence rate is higher with traction-avulsion alone compared to VBO [<a href="#ref-6">6</a>].

### The Role of Surgery in Chronic Nasal Disease
For chronic conditions that do not respond to medical management, surgery may be considered. In human medicine, endoscopic sinus surgery (ESS) is a standard treatment for chronic rhinosinusitis with nasal polyps that is uncontrolled with medication [<a href="#ref-5">5</a>]. While the techniques are different in cats, the principle is similar: surgery aims to remove diseased tissue, open up the nasal passages, and improve drainage. This can provide significant relief for cats with severe, chronic rhinitis or recurrent polyps.

## Unsafe Home Remedies and What to Avoid

When your cat is sneezing blood, it is natural to want to help. However, many common human remedies are dangerous for cats.

- **Do NOT use human decongestants or nasal sprays:** These can be toxic to cats.
- **Do NOT administer any human pain relievers:** Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are highly toxic and often fatal to cats.
- **Do NOT attempt to clean the inside of the nose with cotton swabs:** This can cause further trauma and push foreign material deeper.
- **Do NOT try to stop the bleeding by applying pressure to the nose:** This can cause a cat to panic and may worsen the bleeding.
- **Do NOT give essential oils or herbal remedies:** Many are toxic to cats and can cause severe respiratory distress or liver failure.
- **Do NOT assume it is just a "cold" that will pass:** While mild URIs can resolve on their own, sneezing with blood is a sign of more significant damage and requires professional evaluation.

The safest home care you can provide is to keep your cat in a quiet, comfortable, and stress-free environment. Ensure fresh water is available. You can gently wipe away nasal discharge from the outside of the nose with a soft, damp cloth. Running a humidifier or taking your cat into a steamy bathroom for 10-15 minutes a few times a day can help soothe irritated nasal passages.

## Prevention Strategies

Preventing the underlying causes is the best way to avoid the distress of a bloody sneeze.

- **Vaccination:** Core vaccines for FHV-1 and FCV are essential. While they do not prevent infection entirely, they significantly reduce the severity of the disease. This is a cornerstone of preventative veterinary care.
- **Stress Reduction:** Since stress can trigger herpesvirus flare-ups, minimizing stress is crucial. This includes providing a stable environment, plenty of resources (food, water, litter boxes), and safe hiding places.
- **Good Hygiene:** In multi-cat households, wash your hands between handling cats, and clean food and water bowls regularly.
- **Regular Veterinary Check-ups:** Routine exams can help catch dental disease or early signs of chronic nasal issues before they become severe.
- **Environmental Enrichment:** A stimulating environment can help reduce stress and improve overall health, which in turn supports a stronger immune system.

## Prognosis and Long-Term Outlook

The prognosis for a cat sneezing with blood depends entirely on the cause.

- **For URIs:** The prognosis is generally good. Most cats recover from an acute URI with supportive care. However, some cats become chronic carriers of FHV-1 and may have recurrent episodes of sneezing and nasal discharge throughout their lives. In these cases, the goal is to manage the condition and prevent secondary infections.
- **For Nasal Polyps:** The prognosis is very good after successful surgical removal. Most cats have a complete resolution of their symptoms. The main complication is recurrence, particularly if the polyp's root is not completely removed. This is why a more aggressive surgical approach may be recommended in some cases.
- **For Other Causes:** The prognosis is guarded to poor for nasal tumors and depends on the type and stage of cancer. It is excellent for foreign bodies once they are removed. It is good for bleeding disorders if the underlying cause can be identified and treated.

## Limitations and When to Contact a Veterinarian

This article provides general information about the common causes of a cat sneezing with blood. It is educational and is not a substitute for veterinary diagnosis or treatment. The information presented here cannot predict the specific cause of your cat's condition. Breed-level information, for instance, cannot tell you if your individual cat has a polyp or a tumor. The only way to know is through a professional veterinary examination and diagnostic testing.

**Contact your veterinarian immediately if you observe any of the following:**
- **Continuous or heavy bleeding** from the nose or mouth.
- **Open-mouth breathing, panting, or difficulty breathing.**
- **Pale or white gums** (a sign of blood loss or shock).
- **Lethargy or collapse.**
- **Inability or refusal to eat or drink.**
- **Swelling or deformity of the face.**
- **Dark, coffee-ground-like material** in the vomit or stool (a sign of digested blood).
- **Any signs of bleeding from other parts of the body**, such as blood in the urine or stool, or bruising on the skin.

Do not wait to see if these severe signs resolve on their own. Prompt veterinary care is critical and can be life-saving.

## Frequently Asked Questions

**1. Is a cat sneezing blood an emergency?**
A single, small drop of blood from a violent sneeze may not be an immediate emergency, but it warrants a call to your veterinarian. However, continuous, heavy bleeding, difficulty breathing, lethargy, or pale gums are emergencies that require immediate veterinary care.

**2. Can a cat recover from a bloody nose on its own?**
A cat might recover from a minor episode caused by a simple URI, but the underlying cause will still be present. It is not safe to assume it will resolve on its own. A veterinary examination is necessary to rule out serious conditions like polyps, tumors, or clotting disorders.

**3. What does it mean if my cat sneezes blood and has a runny nose?**
This combination is most commonly associated with a severe upper respiratory infection or a nasal polyp. The inflammation from the infection or the physical presence of the polyp causes both the discharge and the bleeding.

**4. Are nasal polyps in cats cancerous?**
No, nasal polyps are benign (non-cancerous) growths. However, they can still cause significant clinical problems due to their size and location. They are different from malignant nasal tumors, which are cancerous.

**5. How much does it cost to treat a cat with a nasal polyp?**
The cost varies widely depending on the diagnostic tests needed (like a CT scan), the type of surgery required, and your geographic location. It can range from several hundred to a few thousand dollars. Discussing a cost estimate with your veterinarian before proceeding is always best.

**6. Can allergies cause a cat to sneeze blood?**
Allergies can cause sneezing and nasal inflammation, which could theoretically make the nasal lining more fragile. However, allergies are a less common cause of significant bleeding in cats compared to infections or polyps. Your veterinarian can help determine if allergies are a contributing factor.

**7. What should I do if my cat is sneezing blood?**
First, stay calm. Do not try to restrain your cat or pack the nose. Keep your cat in a quiet, confined space. Then, contact your veterinarian or an emergency veterinary clinic immediately to describe the situation and get professional advice on the next steps.

**8. Why does my cat sneeze blood only occasionally?**
Intermittent bleeding is common with chronic conditions like herpesvirus flare-ups or a small, slow-growing nasal polyp. The bleeding may only occur when the inflammation is high or when the polyp is accidentally traumatized by a particularly forceful sneeze. It still requires investigation.

## Limitations and When to Contact a Veterinarian

This article is educational and is not a substitute for veterinary diagnosis or treatment. The information provided here is for general knowledge and should not be used to diagnose or treat your pet. Only a licensed veterinarian can provide a definitive diagnosis and recommend an appropriate treatment plan.

Breed-level information cannot predict the specific health issues of an individual cat. While some breeds may have predispositions to certain conditions, the cause of your cat's sneezing with blood can only be determined through a professional examination. Do not delay seeking veterinary care based on information in this article. If you have any concerns about your cat's health, please contact your veterinarian.

**This article is educational and is not a substitute for veterinary diagnosis or treatment.**

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<a id="ref-14"></a>[<a href="#ref-14">14</a>] [Impact of Anti-IL-5 Therapy (Mepolizumab) on Objective Acoustic Voice Parameters in Type 2 Chronic Rhinosinusitis With Nasal Polyps.](https://pubmed.ncbi.nlm.nih.gov/42521556/)

<a id="ref-15"></a>[<a href="#ref-15">15</a>] [Tezepelumab in Chronic Rhinosinusitis with Nasal Polyps: Pathophysiology, Clinical Evidence, and Therapeutic Perspectives.](https://pubmed.ncbi.nlm.nih.gov/42512965/)

<a id="ref-16"></a>[<a href="#ref-16">16</a>] [Obesity and Its Impact on Endoscopic Sinus Surgery Outcomes in Patients With Chronic Rhinosinusitis With Nasal Polyps.](https://pubmed.ncbi.nlm.nih.gov/42500093/)

<a id="ref-17"></a>[<a href="#ref-17">17</a>] [A Delphi Consensus on Clinical Features, Diagnosis, and Treatment of Chronic Rhinosinusitis With Nasal Polyps in the ASEAN Region.](https://pubmed.ncbi.nlm.nih.gov/42500090/)

<a id="ref-18"></a>[<a href="#ref-18">18</a>] [Sex Hormones and the Risk of Nasal Polyps: A Two-Sample Mendelian Randomization Study.](https://pubmed.ncbi.nlm.nih.gov/42500089/)

<a id="ref-19"></a>[<a href="#ref-19">19</a>] [Integrative Analysis of Plasma Proteome and Genome Reveals Novel Drug Targets for Chronic Rhinosinusitis and Nasal Polyps.](https://pubmed.ncbi.nlm.nih.gov/42500061/)

<a id="ref-20"></a>[<a href="#ref-20">20</a>] [Decreased Production of Tissue Plasminogen Activator in Endothelial Cells From Nasal Polyps.](https://pubmed.ncbi.nlm.nih.gov/42500055/)

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