173. A 9-month-old boy is brought to the emergency department because of an upper respiratory tract infection and decreased appetite for 2 days and rapid breathing for 6 hours. Heis at the 3rd percentile for length and weight. He appears acutely ill. Physical examination shows lethargy and dehydration. Laboratory studies show ketosis, metabolic acidosis,hypoglycemia, anemia, and methylmalonic aciduria. He improves following treatment with intravenous fluids and glucose. Direct sequencing of the patient's leukocyte DNA fails toshow mutations in the methylmalonyl-CoA mutase gene. In addition to dietary protein limitation, administration of which of the following is most appropriate for this patient?A) BiotinB) Folic acidC) NiacinD) Vitamin B6 (pyridoxine)E) Vitamin B12 (cyanocobalamin)

The objective of the question is to identify the most appropriate treatment for a 9-month-old boy…

Answered: 173. A 9-month-old boy is brought to…

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