Abstract

Reply from the Authors: We acknowledge the omission of urinary methylmalonate (MMA) as a test for diagnosis of cobalamin (Cbl) deficiency in our recent editorial on the diagnosis of cobalamin deficiency [1] and we thank Dr. Norman and Dr. Cronin for pointing this out. We certainly concede that urine MMA provides information that is of similar clinical value to that derived from measurement of serum MMA but we do not agree with the contention that urinary MMA is the most accurate test, nor that it should be the initial screening test, for identifying Cbl deficiency. We believe that serum MMA assay does offer several practical advantages over the urine assay. [2] The first is the …

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