Ordering Recommendation

Use to monitor patients with methylmalonic aciduria. Diagnosis of methylmalonic aciduria requires an organic acid panel and appropriate clinical history.

Mnemonic

MMA U

Methodology

Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

24-hour or random urine. Refrigerate 24-hour specimens during collection.

Specimen Preparation

Transfer a 4 mL aliquot from a well-mixed 24-hour or random urine collection to an ARUP Standard Transport Tube and refrigerate or freeze immediately. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form.

Storage/Transport Temperature

Frozen.

Unacceptable Conditions

Room temperature specimens.

Remarks
Stability

Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 1 month

Reference Interval

Test Number
Components
Reference Interval
  MMA - ratio to CRT 0.0-3.6 mmol/mol crt
0020473 Creatinine, Urine - per 24h
Age
Male
Female
3-8 years 140-700 mg/d 140-700 mg/d
9-12 years 300-1300 mg/d 300-1300 mg/d
13-17 years 500-2300 mg/d 400-1600 mg/d
18-50 years 1000-2500 mg/d 700-1600 mg/d
51-80 years 800-2100 mg/d 500-1400 mg/d
81 years and older 600-2000 mg/d 400-1300 mg/d

Interpretive Data

Urinary methylmalonic acid, when increased, is an early and sensitive indicator of vitamin B12 (cobalamin) deficiency. This test can also be used to monitor patients with methylmalonic aciduria. Diagnosis of methylmalonic aciduria requires an organic acid panel and appropriate clinical history.

Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

83921

Components

Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0083919 MMA - per volume 32287-5
0083920 MMA - ratio to CRT 25116-5
0097110 Total Volume 19153-6
0097111 Hours Collected 30211-7
2007350 Methylmalonic Acid, Urine Interpretation 48767-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

Methylmalonic Acid (MMA) Quantitative, Urine