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June 11, 1982

Biotin Deficiency in an Adult During Home Parenteral Nutrition

JAMA. 1982;247(22):3116-3117. doi:10.1001/jama.1982.03320470062035

BIOTIN deficiency in man has been extremely rare, presumably because this vitamin is ubiquitous in the diet and is also produced by the gut flora. Raw egg white contains a protein, avidin, which tightly binds biotin and renders it poorly absorbed. In 1942 Sydenstricker et al1 induced biotin deficiency in adult volunteers by feeding them a diet to which 200 g of dehydrated egg white had been added. Symptoms of biotin deficiency were produced that reversed with daily injections of 75 to 300 μg of biotin. More recent reports have described infants with inborn errors in the metabolism of biotin-dependent enzymes and signs and symptoms of biotin deficiency.2,3 One child with short-bowel syndrome has been described in which signs of biotin deficiency appeared in association with parenteral nutrition and antibiotic therapy, and these signs reversed with administration of 10 mg of biotin a day.4 These investigators presumed this