Are inherited intracellular or cobalamin (Vitamin B12) metabolism defects autosomal recessive?

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Inherited Intracellular Cobalamin Metabolism Defects: Mode of Inheritance

Yes, inherited intracellular cobalamin metabolism defects are autosomal recessive disorders. 1, 2

Inheritance Pattern

  • All inborn errors of intracellular cobalamin metabolism (designated cblA through cblG) are inherited as autosomal recessive traits. 1, 2
  • These single gene defects require inheritance of pathogenic variants from both parents for disease manifestation. 1
  • The disorders affect the intracellular processing and conversion of dietary vitamin B12 into its two metabolically active forms: adenosylcobalamin (AdoCbl) and methylcobalamin (MeCbl). 3

Specific Cobalamin Metabolism Defects

The intracellular cobalamin defects include multiple complementation groups, all following autosomal recessive inheritance:

  • cblA and cblB: Cause isolated methylmalonic acidemia 2
  • cblC: The most common inborn cobalamin metabolism error, causing combined methylmalonic acidemia and hyperhomocysteinemia 3, 2
  • cblD variants: Can cause isolated methylmalonic acidemia (variant 2), isolated hyperhomocysteinemia (variant 1), or combined abnormalities (classic cblD) 2
  • cblE and cblG: Cause isolated hyperhomocysteinemia 2
  • cblF: Causes combined methylmalonic acidemia and hyperhomocysteinemia 2

Clinical Context

  • Most organic acidemias and other inborn errors of metabolism identified through organic acid analysis are inherited as autosomal recessive traits. 4
  • Metabolic disorders associated with autism spectrum disorders are also typically autosomal recessive in nature. 4
  • The identification of an affected individual has important implications for other family members, who may also require metabolic testing and genetic counseling. 4

Important Exception

  • One X-linked cobalamin defect exists (cblX), which is distinct from the intracellular metabolism defects and follows X-linked inheritance rather than autosomal recessive. 5
  • However, this is not classified among the classic intracellular cobalamin metabolism defects (cblA-cblG). 5

References

Research

Inherited errors of cobalamin metabolism and their management.

Bailliere's clinical haematology, 1995

Research

Inborn errors of cobalamin absorption and metabolism.

American journal of medical genetics. Part C, Seminars in medical genetics, 2011

Research

Cobalamin C defect: natural history, pathophysiology, and treatment.

Journal of inherited metabolic disease, 2011

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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