Methylmalonic Acid (MMA) Quantitative, Urine

Abbrev Code:ARMISC   
Order Code:LAB4909Order Name:Send Outs Misc Test
Methodology:Quantitative high performance liquid chromatography/Tandem mass spectrometry
CPT Codes: 83921 x1
Test Includes:Methylmalonic Acid and Creatinine
Turnaround Time:Testing is performed 7 days/week; results are reported within 1-3 days.
Special Instructions:Indicate if patient is taking an antihistamine on the request form.
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Urine Collection Procedure

Collection Instructions

Specimen:Urine, 24 hour collection. Random also acceptable.
Optimal Volume:Submit entire 24 hour collection; analysis requires 6 mL.
Container:3 L plastic jug
Collection Instructions:Refrigerate sample during collection.
Causes for Rejection:Sample stored at room temperature

Processing and Shipping

Specimen Processing:Transfer a 4 mL, 1 mL minimum; aliquot from a well-mixed 24 hour random urine collection to an ARUP Standard Transport tube and refrigerate or freeze immediately. Record total volume and collection time interval on transport tube and test request form.
Shipping Instructions:Ship at frozen temperature.
Stability:1 week refrigerated; 1 month frozen
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:0083918


Reference Range:MMA - ratio to CRT:  0.0 - 3.6 mmol/mol crt
Creatinine, Urine per 24 h
Age Male Female
3-8 y 140-700 mg/d 140-700 mg/d
9-12 y 300-1300 mg/d 300-1300 mg/d
13-17 y 500-2300 mg/d 400-1600 mg/d
18-50 y 1000-2500 mg/d 700-1600 mg/d
51-80 y 800-2100 mg/d 500-1400 mg/d
81 y & older 600-2000 mg/d 400-1300 mg/d
Use: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 in 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.

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