Methylmalonic acidemia is a disorder, passed down through families, in which the body cannot break down certain proteins and fats. The result is a build up of a substance called methylmalonic acid in the blood.
It is considered an inborn error of metabolism.
Causes, incidence, and risk factors
The disease is usually diagnosed in the first year of life. It is an autosomal recessive disorder, which means the defective gene must be passed onto the child from both parents.
About 1 in 48,000 babies are born with this condition. However, the actual rate may be higher, because a newborn may die before the condition is ever diagnosed. Methylmalonic acidemia affects boys and girls equally.
The disease can cause seizures and stroke. Babies may appear normal at birth, but develop symptoms once they start eating more protein, which can cause the condition to get worse.
Brain disease that gets worse (progressive encephalopathy)
Failure to thrive
Repeated yeast infections
Signs and tests
Testing for methylmalonic acidemia is often done as part of a newborn screening exam. The U.S. Department of Health and Human Services recommends screening for this condition at birth because early detection and treatment has been shown to be beneficial.
Tests that may be done to diagnose this condition include:
Seek immediate medical help if a child is having a seizure for the first time. See a pediatrician if your child has signs of failure-to-thrive or developmental delays.
A low-protein maintenance diet can help to reduce the number of acidemia attacks. Persons with this condition should avoid those who are sick.
Genetic counseling may be helpful for couples with a family history of this disorder who wish to have a baby.
Some places have expanded newborn screening done at birth, which includes screening for methylmalonic acidemia. You can ask your doctor if this was done on your child.
Rezvani I, Rosenblatt DS. Valine, leucine, isoleucine, and related organic acidemias. In: Kliegman, RM, Behrman RE, St. Geme III JW, Schor NF, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 79.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.