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Nasal sprays formulated outside the isotonic range (270330 mOsm/kg) can cause irritation and impair the nasal mucociliary clearance apparatus the cilia-driven transport system that moves mucus, particles, and pathogens from the nasal cavity toward the nasopharynx

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Female heterozygotes may be hard to diagnose because of X-chromosome mosaicism leading to a partial deficiency that will not be detected reliably with screening tests