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Clinical, biochemical and genotypical characteristics in biotinidase deficiency

  • Abdurrahman Akgun EMAIL logo , Askin Sen and Hasan Onal
Published/Copyright: August 26, 2021

Abstract

Objectives

Hypotonia, lethargy, eczema, alopecia, conjunctivitis, ataxia, hearing loss, optic atrophy, cognitive retardation, and seizures can occur in patients with biotinidase deficiency, and it is inherited as autosomal recessive. The aim of this study was to evaluate the cases followed up with the diagnosis of biotinidase deficiency in our unit, in terms of clinical, biochemical and genetic analyses.

Methods

A total of 112 cases followed up in our centre with the diagnosis of biotinidase deficiency between August 2018–September 2020 were included in the study. Data were collected retrospectively.

Results

A total of 112 cases (55.4% male, mean age: 2.2 ± 2.8 years) diagnosed with biotinidase deficiency were evaluated. Diagnoses were made by newborn screening in 90.2% of the cases, by family screening in 4.5%, and by investigating symptoms in 5.4%. The most frequently (27.5%) detected mutations were c.1330G>C (p.D444H)/c.1330G>C (p.D444H) homozygous mutation, followed by (13.0%) c.1330G>C (p.D444H)/c.470G>A (p.R157H) compound heterozygous mutation, and (13.0%) c.470G>A (p.R157H)/c.470G>A (p.R157H) homozygous mutation. Biotinidase enzyme levels were found to be higher in patients with the p.D444H homozygous mutation than patients with other mutations. Biotin treatment was started in all patients with enzyme deficiency.

Conclusions

Since the treatment is inexpensive and easily available, it is vital to detect this disease before symptom onset, especially findings related to the central nervous system, hearing and vision loss. In patients diagnosed with enzyme deficiency, the diagnosis should be definitively confirmed by genetic analysis.


Corresponding author: Abdurrahman Akgun, Department of Pediatrics, Division of Metabolism, Firat University School of Medicine, University Road, Yunus Emre Avenue, No: 20, 23200, Elazig, Turkey, E-mail:

Acknowledgements

We would like to acknowledge the contribution of the management and staff of the University of Firat Hospital.

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interest: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: This study was approved by the Local Ethics Committee of the Firat University School of medicine (protocol: E-97132852-050.01.04-13964, 11/02/2021).

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Received: 2021-04-04
Accepted: 2021-08-09
Published Online: 2021-08-26
Published in Print: 2021-11-25

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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