Defects in the metabolic pathways of methylmalonic acid , succinic acid, and vitamin B12 activity are responsible for the bouts of acidosis and ketosis. Infection or high protein intake may precede episodes of acidosis.
Untreated acidosis progresses to coma followed by death.
Large doses of vitamin B12 may be given during acute attacks. A low-protein diet must be maintained. Recurrent attacks of acidosis are expected. Call to see your health care provider immediately if you develop signs of acidosis such as headache , decreased alertness , disorientation, blurred vision , irritability, or restlessness .