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IEMbase 0087: MMAB-related methylmalonic aciduria, cblB type

Scope

Field Value
IEMbase ID 87
Nosology 21.9.15.01
Gene MMAB
External IDs OMIM:251110
Generated mapping MAPPED by alias_exact:cblb
Candidate DisMech targets Inborn_Disorder_of_Cobalamin_Metabolism_and_Transport.yaml#cblB
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents this as autosomal recessive MMAB-related methylmalonic aciduria, vitamin B12-responsive cblB type. Treatability is marked yes.

The characteristic clinical rows include acidosis, dehydration, acute encephalopathic crisis, failure to thrive, ketosis, life-threatening illness, and vomiting.

The biochemical panel includes elevated urinary and plasma methylmalonic acid, urinary methylcitric acid, urinary 3-hydroxypropionic acid, C3 propionylcarnitine in blood or plasma, C3 acylcarnitine ratios, ammonia, anion gap, lactate, total plasma homocysteine, and free carnitine in dried blood spot or plasma.

Treatment rows include antibiotics, avoidance of fasting, carnitine, hemodialysis, hydroxycobalamin, liver and/or kidney transplantation, carglumic acid, peritoneal dialysis, protein-defined diet, sick-day management, and sodium benzoate.

DisMech phenotype coverage

The generated mapping to Inborn_Disorder_of_Cobalamin_Metabolism_and_Transport.yaml#cblB is correct.

DisMech models cblB as an MMAB subtype impairing adenosylcobalamin synthesis and producing isolated methylmalonic acidemia. The cobalamin umbrella covers the adenosylcobalamin branch, impaired methylmalonyl-CoA mutase activity, elevated methylmalonic acid, and hydroxocobalamin-based treatment context.

Methylmalonic_Acidemia.yaml is also relevant secondary coverage. It explicitly lists MMAB as the cblB complementation group, notes that cblB-type MMA tends to be more severe than cblA-type, and covers acute decompensation, propionylcarnitine, methylcitric acid, hyperammonemia, chronic MMA complications, protein-restricted diet, carnitine, hydroxocobalamin, crisis management, and transplantation.

Concordance and completeness

Judgement: correct mapping and high concordance.

The direct subtype target is the cobalamin umbrella. The isolated MMA entry is useful for severity and management details. IEMbase adds granular emergency and dialysis rows, plus carglumic acid and sodium benzoate, that are not all enumerated in the local cblB subtype.

Curation actions

  • Keep the generated mapping to Inborn_Disorder_of_Cobalamin_Metabolism_and_Transport.yaml#cblB.
  • Treat Methylmalonic_Acidemia.yaml as important secondary context for phenotype and management coverage.
  • No separate MMAB-only file is needed unless isolated MMA is later split by complementation group.