Evidence map›Paper›PMID 41776364›Full record

ArticlePediatric research2026

Unveiling clinical and genetic landscapes of MMA and CBS: insights from whole exome sequencing in a tertiary care setting.

Muhammad Wasim, Iram Javed, Afia Iqbal, Nadia Mustafa, Haq Nawaz Khan, Tipu Sultan, Yajun Wang, Guoda Ma

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Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Muhammad WasimMaternal and Children's Health Research Institute, Shunde Women and Children's Hospital, Guangdong Medical University, Foshan, 528300, China. mm.waseemjee@gmail.com.
Iram JavedChildren Hospital & Institute of Child Health, Faisalabad, 38000, Pakistan. dr.iramjaved@gmail.com.
Afia IqbalLahore College for Women University, Lahore, 54600, Pakistan.
Nadia MustafaDepartment of Biotechnology, University of Health Sciences, Lahore, 54600, Pakistan.
Haq Nawaz KhanPathology and Laboratory Medicine, The Aga Khan University, Karachi, 74800, Pakistan.
Tipu SultanUniversity of Child Health Sciences, The Children's Hospital Lahore, Karachi, 54600, Pakistan.
Yajun WangInstitute of Pediatrics, Shunde Women and Children's Hospital, Guangdong Medical University, Foshan, 528300, China.
Guoda MaMaternal and Children's Health Research Institute, Shunde Women and Children's Hospital, Guangdong Medical University, Foshan, 528300, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMMA and CBS deficiency are rare autosomal recessive metabolic disorders caused by defects in cobalamin metabolism and cystathionine-beta-synthase activity, respectively. Advanced molecular genetic techniques, have become essential for diagnosing these conditions. This study aimed to analyze the genetic variations in three MMA and four CBS deficiency cases using WES and correlate the findings with clinical, biochemical, and treatment outcomes.

methodsClinical evaluation, biochemical testing, neuroimaging, and WES were performed. WES data were analyzed using the reference genome GRCh37, and variants were classified according to ACMG guidelines. Treatment outcomes were monitored for three months post-intervention.

resultsIn MMA cases, a homozygous pathogenic variant (c.394 C > T, p.Arg132Ter) in MMACHC was identified in all three patients. Biochemical abnormalities included methylmalonic aciduria, elevated homocysteine, and megaloblastic anemia. Hydroxycobalamin therapy improved behavioral, cognitive, and dermatological symptoms, though residual neuropathy persisted in one case. In CBS deficiency, pathogenic variants in CBS (c.992 C > T, p.Ala331Val; c.862 G > A, p.Ala288Thr; c.700 G > A, p.Asp234Asn) were identified. Clinical features included developmental delayed milestones, lens dislocation, and vascular complications. Treatment outcomes varied based on early diagnosis and compliance.

conclusionThis study highlights the importance of newborn screening program with WES in diagnosing and managing MMA and CBS deficiency, facilitating early intervention, improving clinical outcomes, and supporting precision medicine approaches. IMPACT: Early newborn screening and diagnosis are critical for effective treatment and improved patient outcomes. Novel clinical and pathogenic variants will expand the current understanding of these disorders. WES enhances the diagnostic precision for MMA and CBS deficiency, facilitating timely intervention and superior clinical management. Accurate and early detection of treatable IEMs through NBS can significantly reduce disease burden and healthcare costs.

Indexed as

Amino Acid Metabolism, Inborn ErrorsCystathionine beta-SynthaseExome SequencingHomocystinuriaAdolescentCarrier ProteinsChildChild, PreschoolFemaleHomozygoteHumansHydroxocobalaminInfantMaleMutationOxidoreductasesCarrier ProteinsCystathionine beta-SynthaseHydroxocobalaminMMACHC protein, humanOxidoreductasesVitamin B 12

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.