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These include deficiencies of vitamin B12, folate or niacin, and infective causes including cryptococcal meningitis, HIV, Lyme disease, progressive multifocal leukoencephalopathy, subacute sclerosing panencephalitis, syphilis and Whipple's disease

After that, bacterial contamination becomes more likely even with refrigeration

Hum Genet 2011

Peptides should be stored in a cool, dry place away from direct sunlight

Rash, possibly with pain in the joints Irreversible visual impairment has been reported in isolated cases of critically ill patients who have received omeprazole intravenous injection, especially at high doses, but no causal relationship has been established