Effect of vitamin B12 derivatives on urinary excretion of methylmalonic acid in liver diseases

1. Twenty.one patients with liver diseases were studied for their urinary mehylmalonic acid excretion after a valine load by means of an improved thin layer chromatography. 2. Methylmalonic acid positive cases were found in four out of the ten patients with cirrhosis of the liver, all four with cirrhosis and diabetes mellitus, and none with acute hepatitis of icteric phase. No apparent correlation was found between the methylmalonic acid excretion and the extent of hepatic damage. 3. A large amount of methylmalonic acid found in the case (S. I.) with cirrhosis of the liver and diabetes mellitus after the valine load was not corrected by cyanocobalamin but by DBCC, suggesting an impaired transformation from cyanocobalamin to DBCC. However, the nature of the impairment remains unknown.