Background: Propionic acidemia (PA) is an inborn error of metabolism (IEM) that typically presents in the newborn. The Amish of North America have an increased prevalence of PA due to a founder variant in the PCCB gene. The Amish PA phenotype is variable. and some individuals remain asymptomatic and undiagnosed until adulthood. https://www.roneverhart.com/Gretsch-G5210T-P90-Electromatic-Jet-Two-90-Single-Cut-Electric-Guitar-w-Bigsby-Mako-p23063/