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The robust presence of innate immune elements at the leading edges led some to conclude that in these chronic active MS lesions, there is a switch with the innate rather than the adaptive immune system taking over to propagate the pathology (Weiner, 2008)

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The most common coding risk is the Q21.4 exclusion: coders who confuse aortopulmonary window with true truncus arteriosus will misassign the code