Combined Methylmalonic Acidemia and Homocystinuria, CblC Type. I. Clinical Presentations, Diagnosis and Management

Overview

Journal J Inherit Metab Dis

Publisher Wiley

Date 2011 Jul 13

PMID 21748409

Citations 103

Authors

Nuria Carrillo-Carrasco

Randy J Chandler

Charles P Venditti

Affiliations

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Abstract

Combined methylmalonic acidemia and homocystinuria, cblC type, is an inborn error of intracellular cobalamin metabolism with a wide spectrum of clinical manifestations that is stated to be the most common inherited disorder of cobalamin metabolism. This metabolic disease is caused by mutations in the MMACHC gene and results in impaired intracellular synthesis of adenosylcobalamin and methylcobalamin, cofactors for the methylmalonyl-CoA mutase and methionine synthase enzymes. Elevated methylmalonic acid and homocysteine with decreased methionine production are the biochemical hallmarks of this disorder. Awareness of the diverse clinical presentations associated with cblC disease is necessary to provide a timely diagnosis, to guide management of affected individuals and to establish a framework for the future treatment of individuals detected through expanded newborn screening. This article reviews the biochemistry, clinical presentations, genotype-phenotype correlations, diagnosis and management of cblC disease.

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