Methylmalonate Excretion in a Patient with Pernicious Anemia

Abstract

METHYLMALONIC acid is excreted in large amounts by rats,1 especially in those in which liver necrosis develops.2 Its excretion in human metabolism has not been established. Since vitamin B12 has been found to be essential, in vitro, for the isomerization of methylmalonate to succinate3 4 5 the urine of a patient with primary pernicious anemia was examined for the presence of methylmalonate. Methylmalonic acid was found in large quantities.Case ReportH.G., a 69-year-old man, was admitted to the Hospital of the University of Pennsylvania on April 16, 1962. In 1941 a gastric analysis revealed achlorhydria. In 1959 he was treated . . .