Test Code MMAU Methylmalonic Acid, Quantitative, Urine
Reporting Name
Methylmalonic Acid, QN, UUseful For
Evaluating children with signs and symptoms of methylmalonic acidemia using urine specimens
Evaluating individuals with signs and symptoms associated with a variety of causes of vitamin B12 (cobalamin) deficiency
Performing Laboratory
Mayo Clinic Laboratories in RochesterSpecimen Type
UrineSpecimen Required
Patient Preparation: Overnight fast required
Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 4 mL
Collection Instructions: Collect second-voided specimen after an overnight fast.
Specimen Minimum Volume
1.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Frozen (preferred) | 28 days | |
Refrigerated | 28 days | ||
Ambient | 21 days |
Reference Values
<3.60 mmol/mol creatinine
Day(s) Performed
Monday through Friday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
83921
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MMAU | Methylmalonic Acid, QN, U | 25116-5 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
80290 | Methylmalonic Acid, QN, U | 25116-5 |
Interpretation
In pediatric patients, markedly elevated methylmalonic acid values indicate a probable diagnosis of methylmalonic acidemia. Additional confirmatory testing must be performed.
In adults, moderately elevated values indicate a likely vitamin B12 (cobalamin) deficiency.
Clinical Reference
1. Fenton WA, Gravel RA, Rosenblatt DS. Disorders of propionate and methylmalonate metabolism. In: Valle D, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. The Online Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill; 2019. Accessed November 27, 2023. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225086103&bookid=2709
2. Klee GG. Cobalamin and folate evaluation: Measurement of methylmalonic acid and homocysteine vs vitamin B(12) and folate. Clin Chem. 2000;46(8 Pt 2):1277-1283
3. Watkins D, Rosenblatt DS. Inherited disorders of folate and cobalamin transport and metabolism. In: Valle D, Antonarakis S, Ballabio A, Beaudet AL, Mitchell GA, eds. The Online Metabolic and Molecular Basis of Inherited Disease. McGraw-Hill; 2014. Accessed November 27, 2023. Available at https://ommbid.mhmedical.com/content.aspx?sectionid=225548307&bookid=2709
4. Vashi P, Edwin P, Popiel B, Lammersfeld C, Gupta D. Methylmalonic acid and homocysteine as indicators of vitamin B-12 deficiency in cancer. PLoS One. 2016;11(1):e0147843
Report Available
3 to 5 daysMethod Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Biochemical Genetics Test Request (T798)
-Benign Hematology Test Request (T755)