Which of the following symptoms is NOT associated with Propionic Acidemia?

Propionic Acidemia is a metabolic disorder caused by a deficiency of the enzyme propionyl-CoA carboxylase, leading to the accumulation of propionyl-CoA and related byproducts. This condition often manifests with several clinical features.

Vomiting is a common symptom due to the toxicity of metabolites accumulating in the body and the body's response to metabolic crises. Cognitive decline can occur because of the effects of the metabolic disorder on the brain, particularly due to the impact of toxic metabolites on neurological function.

Hepatosplenomegaly, or the enlargement of the liver and spleen, is also frequently observed in individuals with Propionic Acidemia as a result of metabolic disturbances and liver stress.

In contrast, severe abdominal pain is not typically a symptom associated with Propionic Acidemia. While patients may experience some gastrointestinal discomfort, severe abdominal pain is more indicative of other conditions or complications rather than a direct symptom of Propionic Acidemia itself. Therefore, the correct answer indicates a symptom that is less characteristic of the disease's clinical profile.