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In the case of secondary amenorrhea, it is necessary to exclude pregnancy by testing the serum level of beta subunit of human chorionic gonadotropin (beta-HCG) and the concentration of thyroid stimulating hormone and prolactin, as endocrine diseases can lead to menstrual disorders (215)

observed reduced OXPHOS and a shift toward glycolysis in CD4 + T cells from patients with progressive MS, particularly in the primary progressive (PP) form (172)