American Journal of Clinical Nutrition, Vol 21, 173-182, Copyright © 1968 by The American Society for Clinical Nutrition, Inc.

Human Biotin Deficiency

A Case History of Biotin Deficiency Induced by Raw Egg Consumption in a Cirrhotic Patient

¹ From the Division of Nutrition, Department of Medicine, Medical College of Alabama, Birmingham, Alabama

1) A 62-year-old white female developed clinical manifestations of biotin deficiency after consuming a diet containing six raw eggs daily for 18 months. The diet was advised by a well-meaning physician to aid liver regeneration following a diagnosis of Laennec's cirrhosis.

2) Clinical manifestations included anorexia, nausea, vomiting, glossitis, pallor, depression, lassitude, substernal pain, scaly dermatitis, and desquamation of the lips. All symptoms cleared or improved markedly after 2-5 days of parenteral vitamin therapy providing 200 µg of biotin daily, while she continued her pretreatment diet. In contrast to other case reports, she did not exhibit anemia, muscle pains, hypercholesterolemia, or electrocardiographic abnormality.

3) Nornmal subjects were observed to remove free, injected biotin from the blood within 3-5 hr, excreting 55 and 27% in the urine in 24 hr after injection. In contrast, free biotin did not disappear from the patient's blood for approximately 8 hr, and 91% of the those appeared in the urine. These results suggest that hepatic cirrhosis prevented the proper storage and utilization of biotin in this patient.