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.

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 19146-0
* 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