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August 26, 1983

Biotin Deficiency Complicating Parenteral Alimentation-Reply

Author Affiliations


JAMA. 1983;250(8):1028. doi:10.1001/jama.1983.03340080018018

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In Reply.—  We certainly agree that the article by Mock et al represents the first report of biotin deficiency complicating parenteral alimentation. Indeed, it was this article that directed our thinking toward biotin deficiency in our patients.Dr Mock is concerned that we "did not document biotin deficiency in the patient described." Dr Herman Baker kindly consented to measure biotin levels for us as he did in Mock's case, but, unfortunately, our specimens had been frozen and thawed so many times looking at various trace metals and fatty acids as possible sources of the patient's problems that the specimens became bacterially contaminated and unfit for biotin analysis. However, we believe that our patient's condition does represent a case of biotin deficiency for the following reasons:

  1. The patient had skin lesions typical of biotin deficiency that rapidly corrected with MVI-12 administration (with biotin being the only new nutrient).

  2. Slit-lamp examination showed