Biotin Deficiency in a Patient with Short Bowel Syndrome during Home Parenteral Nutrition

A 54-year-old woman with short bowel syndrome developed biotin deficiency, characterized by complete hair loss and other symptoms, after six months on home parenteral nutrition lacking biotin. Initial tests showed low serum and urine biotin levels. Treatment with oral biotin (10 mg/day) led to new hair growth and symptom resolution within three weeks, with improved biotin levels. Subsequent intravenous biotin (5 mg/day) further increased biotin levels. The patient was maintained on an intravenous multivitamin with biotin and remained free of deficiency symptoms.