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Clinical and Basic Investigations of Methylmalonic Acidemia (MMA) and Related Disorders
Diagnostic Criteria and Testing for MMA
To enroll in the study, patients must:
- Be between 2 and 70 years of age and have a diagnosis of MMA
To participate in the study, patients will be admitted to the National Institutes of Health (NIH) Clinical Center for 4 to 5 days every year for 5 to 10 years and undergo the following tests and procedures:
- A complete medical history, physical examination and eye examination.
- Consultations from dentists and specialists for the nervous system, digestive
tract, endocrine and kidney, as needed.
- A 24-hour urine collection to examine for methylmalonic acid, other acids,
sugar and proteins to measure kidney function.
- Blood test to assess liver and thyroid function, blood counts and blood
chemistries, methylmalonic acid levels, and for genetic tests and basic research
studies.
- A blood test to measure growth hormone production.
- For this test, a very small amount of blood is collected overnight (every
20 to 30 minutes from 8:00 p.m. to 8:00 a.m.) through an intravenous catheter
(plastic tube placed in a vein). The total amount of blood drawn is approximately
one tablespoon. Patients who have stopped growing or whose weight does
not permit collection of one tablespoon of blood do not undergo this procedure.
- Frequent blood pressure measurements, including overnight monitoring.
- Skin biopsy for cell culture (cells to grow in the laboratory for future
testing).
- For this procedure, an area of skin is numbed with an anesthetic such
as lidocaine. A 4-mm diameter circular area is then removed using a sharp
punch and scissors. The wound is dressed and usually heals within a week.
- Photographs of the face and body (wearing underwear) to help track growth
and appearance.
- Ultrasound of the kidneys.
- Hand x-ray to determine bone age.
- Dual energy x-ray absorptionometry (DEXA) scan to assess bone density. For
the DEXA scan, the patient lies still on a table while the spine and hip are
scanned using a small amount of radiation.
Last Reviewed: August 4, 2008
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