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472,473 Recent advancements in imaging and motility testing have enhanced the early diagnosis of GAN, utilizing tools such as high-resolution manometry and wireless motility capsules

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The patients with cblC were treated with hydroxocobalamin (OHCbl) (1 mg/day, intramuscular injection), betaine (100500 mg/kg/day, oral administration), folic acid(50 mg/day, oral administration),vitamin B6 (1030 mg/day, oral administration), sodium benzoate(150250 mg/kg/day, improve hyperammonemia), levocarnitine (50 mg/kg/day, oral administration), low protein and high-energy diet to reduce the accumulation of toxic metabolites

Acknowledgements The authors are also grateful for the platform support provided by the China-Japan Friendship Hospital

Although multiple PTMs have been identified in MMAemia, their precise pathophysiological contributions and therapeutic potential remain poorly understood