Initial signs/symptoms may include:
- hyperventilation, laryngeal stridor, and/or apnea
- eczematoid rash
Older children may manifest:
- limb weakness
- developmental delay
- neurosensory hearing loss
- optic atrophy and scotomata
- recurrent viral and fungal infections
Children with untreated partial biotinidase deficiency may manifest any of the above symptoms, though generally they will be mild and occur only with concomitant stressors, such as prolonged infection.
- Contact the family and evaluate the infant for poor feeding, lethargy, or hypotonia.
- Provide emergency treatment/referral if symptoms are present (see the ACT Sheet for Biotinidase deficiency).
- To confirm the diagnosis, work with the following service(s): we currently have no Newborn Screening Programs service providers listed, please search our Services database for related services.
- For evaluation and ongoing collaborative management, consult the following service(s): we currently have no Pediatric Genetics service providers listed, please search our Services database for related services.
- Educate the family regarding signs, symptoms, and the need for urgent care when the infant becomes ill.
- Start oral biotin at 5mg bid and assure continuation for life in patients with profound biotinidase deficiency. Patients with partial deficiency might require lower doses after the first year of life.
- For those identified after irreversible consequences, assist in management, particularly with low vision aids, hearing aids or cochlear implants, developmental and educational interventions.
Revealing Biotinidase (UDOH) ( 226 KB)
Five pages of detail on biotinidase deficiency, including screening, pathophysiology, management, and Quick Facts; from the Utah Newborn Screening Program, Utah Department of Health
Biotinidase Deficiency (GeneReviews)
An expert-authored, peer-reviewed, current disease description that applies genetic testing to diagnosis and management information for the condition; National Center for Biotechnology Information, U.S. National Library of Medicine.
Resources for Biotinidase Deficiency (Disease InfoSearch)
Compilation of information, articles, research, case studies, and genetics links; from Genetic Alliance.
Genetics in Primary Care Institute (AAP)
The goal of this site is to increase collaboration in the care of children with known or suspected genetic disorders. It includes health supervision guidelines and other useful resources; represents a collaboration among the Health Resources & Services Administration, the Maternal and Child Health Bureau, and the American Academy of Pediatrics.
Biotinidase Deficiency (Genetics Home Reference)
Excellent, detailed review of condition for patients and families; U.S. National Library of Medicine.
Biotinidase Deficiency Family Support Group
Support group site with information, links, and a "Family Center" with an email forum, chance to meet other families, and read stories.
Baby's First Test (Genetic Alliance)
A clearinghouse for newborn screening information. Provides resources about screening at the local, state, and national levels and ways for people to share their viewpoints and questions about newborn screening.
ACT Sheet for Elevated C5-OH Acylcarnitine (ACMG) ( 400 KB)
Contains short-term recommendations for clinical follow-up of the newborn who has screened positive; American College of Medical Genetics.
Newborn Screening ACT Sheets & Confirmatory Algorithms (ACMG)
ACTion (ACT) Sheets and algorithms for responding to positive newborn screening test results, membership required; American College of Medical Genetics.
We currently have no Newborn Screening Programs service providers listed; search our Services database for related services.
We currently have no Pediatric Genetics service providers listed; search our Services database for related services.
For other services related to this condition, browse our Services categories or search our database.
Clinical issues and frequent questions about biotinidase deficiency.
Mol Genet Metab. 2010;100(1):6-13. PubMed abstract