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IEMbase 0136: ALDH6A1-related Methylmalonate semialdehyde dehydrogenase deficiency

Scope

Field Value
IEMbase ID 136
Nosology 1.2.17.01
Gene ALDH6A1
External IDs OMIM:603178; ORPHA:289307
Generated mapping UNMAPPED
Candidate DisMech targets No valid ALDH6A1/MMSDH target found; generated SSADH candidate is false
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents this as ALDH6A1-related methylmalonate semialdehyde dehydrogenase deficiency, abbreviated MMSDH. Treatability is marked unknown.

Characteristic biochemical rows include normal-to-increased urinary 2-aminoisobutyric acid, 3-aminoisobutyric acid, 3-hydroxyisobutyric acid, and ethylmalonic acid. Other rows include normal-to-increased methionine, beta-alanine, 3-hydroxypropionic acid, lactate, and decreased fibroblast methylmalonic semialdehyde dehydrogenase activity. Clinical rows include developmental delay, hepatomegaly, episodic vomiting, and failure to thrive.

DisMech phenotype coverage

No local standalone ALDH6A1/MMSDH entry was found. The generated Succinic_Semialdehyde_Dehydrogenase_Deficiency.yaml candidate is a false semialdehyde-dehydrogenase neighbor: SSADH deficiency is an ALDH5A1 disorder of GABA catabolism with GABA/GHB accumulation, not ALDH6A1 methylmalonate semialdehyde metabolism.

HIBCH deficiency and other valine-catabolism entries are pathway neighbors but do not cover ALDH6A1 disease scope.

Concordance and completeness

Judgement: true unmapped local disease gap.

The IEMbase record has a recognizable MMSDH biochemical pattern involving aminoisobutyric acids, 3-hydroxyisobutyric acid, ethylmalonic acid, and reduced MMSDH enzyme activity. Current DisMech captures adjacent valine or GABA pathway disorders, but not the ALDH6A1 disease entity.

Curation actions

  • Keep this record unmapped.
  • Reject the SSADH/ALDH5A1 candidate.
  • Future curation should add ALDH6A1/MMSDH deficiency with the urinary organic acid and aminoisobutyric acid profile, failure to thrive, developmental delay, hepatomegaly, vomiting, and valine/thymine-catabolism mechanism.