TLDR A rare biotin deficiency in an Iraqi family caused severe symptoms but was successfully treated with lifelong biotin.
A rare case of biotin deficiency was reported in a family from Wasit Province, involving seven children, three of whom died before diagnosis. Symptoms included ataxia, hypotonia, developmental delay, conjunctivitis, skin rash, dermatitis, alopecia, hearing difficulty, breathing problems, and recurrent chest infections. Diagnosis was confirmed through a therapeutic trial with vitamin replacement and a biotinidase enzyme assay conducted in France. The surviving children are now doing well on lifelong treatment with activated biotin.
Older people tend to have higher biotin levels, which are weakly linked to certain blood components and negatively linked to triglycerides; biotin should be checked in patients with high triglycerides or medication-related skin issues, and only supplemented if deficient. Vitamin D and folate deficiencies are linked to specific skin conditions.
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