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This occurs in conditions such as pernicious anemia, an autoimmune condition that affects the production of intrinsic factor, which is necessary for the absorption of B12 in the small intestine

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Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect: Signs of an allergic reaction, like skin rash, hives with itching and red swollen blistered peeling skin with or without fever, wheezing, tightness in the chest or throat, trouble breathing, trouble swallowing, trouble talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat

Poirier VJ, Thamm DH, Kurzman ID, Jeglum KA, Chun R, Obradovich JE, OBrien M, Fred RM 3rd, Phillips BS, Vail DM (2002): Liposome-encapsulated doxorubicin (Doxil) and doxorubicin in the treatment of vaccine-associated sarcoma in cats