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Current practice recommendations published by expert communities recommend a two-step approach starting with a test for glutamate dehydrogenase (GDH), followed closely by a toxin test and/or a nucleic acid test. Alternatively, in establishments where well-known clinical formulas guide assessment, a nucleic acid test alone is acceptable. Nucleic acid tests would be the methods of option in around 50% of laboratories in the us. These tests are considered as the utmost sensitive method
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