Order Code LAB6636 Methylmalonic Acid, Quantitative, Urine
Additional Codes
Mayo Test ID |
---|
MMAU |
Reporting Name
Methylmalonic Acid, QN, UUseful For
Evaluating children with signs and symptoms of methylmalonic acidemia using urine specimens
Evaluating individuals with signs and symptoms associated with a variety of causes of vitamin B12 (cobalamin) deficiency
Specimen Type
UrineSpecimen Required
Patient Preparation: Overnight fast required
Supplies: Urine Tubes, 10 mL (T068)
Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 4 mL
Collection Instructions: Collect second-voided specimen after an overnight fast.
Specimen Minimum Volume
1.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Urine | Frozen (preferred) | 28 days |
Refrigerated | 28 days | |
Ambient | 21 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
<3.60 mmol/mol creatinine
Performing Laboratory

Day(s) Performed
Monday through Friday
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
CPT Code Information
83921
Method Description
Methylmalonic acid (MMA) is determined by liquid chromatography tandem mass spectrometry (LC-MS/MS) stable isotope dilution analysis. The specimen is mixed with an internal standard (methyl-d3-malonic acid). MMA and d3-MMA are isolated by solid phase extraction. LC-MS/MS is performed using mobile phases and a short column to separate MMA and d3-MMA from the bulk of the specimen matrix. The MS/MS is operated in the multiple reaction monitoring (MRM) negative mode to follow the precursor to product species transitions. Separation of MMA/d3-MMA from the more physiologically abundant succinic acid is accomplished by the careful selection of MRM transitions and optimization of the LC separation. The ratios of the extracted peak areas of MMA to d3-MMA determined by LC-MS/MS are used to calculate the concentration of MMA present in the sample.(Unpublished Mayo method)
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Biochemical Genetics Test Request (T798)
-Benign Hematology Test Request (T755)