 MMA is an autosomal recessive inherited inborn error of metabolism, characterized by recurrent episodes of vomiting, lethargy, profound ketoacidosis, hyperammonemia, and pancytopenia in infancy, and may cause early death.Complications include cardiomyopathy, metabolic stroke, pancreatitis, and progressive renal failure.Either mutations to the gene "MUT" (encodes methylmalonyl-CoA mutase), or "MMAA" (encodes a chaperone protein of methylmalonyl-CoA mutase, "MMAA" protein) can lead to methylmalonyl acidemia.