Combined malonic and methylmalonic aciduria

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Combined malonic and methylmalonic aciduria
Synonyms	CMAMMA
Pronounce
Specialty	Medical genetics
Symptoms	Developmental delay, seizures, metabolic acidosis
Complications	N/A
Onset	Infancy or early childhood
Duration	Lifelong
Types	N/A
Causes	Mutations in the ACSF3 gene
Risks	Genetic inheritance
Diagnosis	Genetic testing, urine organic acid analysis
Differential diagnosis	Methylmalonic acidemia, Malonic aciduria
Prevention	N/A
Treatment	Dietary management, vitamin B12 supplementation
Medication
Prognosis	Variable, depends on severity and management
Frequency	Rare
Deaths

Propionate Pathway

Combined Malonic and Methylmalonic Aciduria (CMAMMA) is a rare metabolic disorder characterized by the accumulation of malonic acid and methylmalonic acid in the body. This condition is caused by mutations in the ACSF3 gene, which plays a crucial role in the metabolism of certain types of fats and proteins. Individuals with CMAMMA may experience a wide range of symptoms, including developmental delay, intellectual disability, muscle weakness, and failure to thrive. Early diagnosis and management are critical for improving the quality of life for affected individuals.

Causes

CMAMMA is caused by mutations in the ACSF3 gene. This gene is responsible for encoding a protein that is involved in the metabolism of certain lipids and amino acids. Mutations in the ACSF3 gene disrupt this metabolic pathway, leading to the accumulation of malonic acid and methylmalonic acid in the body.

Symptoms

The symptoms of CMAMMA can vary widely among affected individuals. Common symptoms include:

• Developmental delay
• Intellectual disability
• Muscle weakness
• Failure to thrive
• Feeding difficulties
• Seizures
• Metabolic acidosis

Diagnosis

Diagnosis of CMAMMA typically involves a combination of clinical evaluation, family history, and laboratory tests. Laboratory tests may include blood and urine tests to measure the levels of malonic acid and methylmalonic acid. Genetic testing can confirm a diagnosis by identifying mutations in the ACSF3 gene.

Treatment

There is no cure for CMAMMA, but treatment focuses on managing symptoms and preventing metabolic crises. Treatment strategies may include:

• Dietary restrictions to limit the intake of certain fats and proteins
• Supplementation with vitamins and minerals
• Medications to manage symptoms such as seizures
• Regular monitoring of acid levels in the blood and urine

Prognosis

The prognosis for individuals with CMAMMA varies depending on the severity of symptoms and the effectiveness of management strategies. Early diagnosis and intervention can improve the quality of life for affected individuals.

NIH genetic and rare disease info

• NIH info on Combined malonic and methylmalonic aciduria

Combined malonic and methylmalonic aciduria is a rare disease.