TY - JOUR
T1 - A case of holocarboxylase synthetase deficiency with insufficient response to prenatal biotin therapy
AU - Yokoi, Kyoko
AU - Ito, Tetsuya
AU - Maeda, Yasuhiro
AU - Nakajima, Yoko
AU - Kurono, Yukihisa
AU - Sugiyama, Naruji
AU - Togari, Hajime
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2009/11
Y1 - 2009/11
N2 - Holocarboxylase synthetase (HCS) deficiency is an inborn error of biotin metabolism, leading to a multiple carboxylases deficiency. As the affected fetus sometimes presents with enlargement of the cerebral ventricles and intrauterine growth retardation (IUGR), prenatal administration of biotin has been attempted in some pregnancies. We present herein the case of a Japanese neonate with HCS deficiency who received maternal administration of biotin (10 mg/day) from 33 weeks' gestation. After biotin administration, the fetal body weight increased and gestation was continued to full term. However, lactic acidemia and metabolic acidosis were observed after birth. To evaluate the effects of prenatal therapy, we collected serum samples and measured the acylcarnitine profiles using high-performance liquid chromatography electrospray ionization tandem mass spectrometry. At birth, levels of propionylcarnitine and 3-hydroxyisovalerylcarnitine had already increased. At 2 h after birth, these levels of acylcarnitines were further increased. At 3.5 h after the start of biotin, these chemical findings were slightly improved. In conclusion, we considered that prenatal biotin therapy at 10 mg/day may have been inadequate to avoid neonatal acidotic crisis in this case.
AB - Holocarboxylase synthetase (HCS) deficiency is an inborn error of biotin metabolism, leading to a multiple carboxylases deficiency. As the affected fetus sometimes presents with enlargement of the cerebral ventricles and intrauterine growth retardation (IUGR), prenatal administration of biotin has been attempted in some pregnancies. We present herein the case of a Japanese neonate with HCS deficiency who received maternal administration of biotin (10 mg/day) from 33 weeks' gestation. After biotin administration, the fetal body weight increased and gestation was continued to full term. However, lactic acidemia and metabolic acidosis were observed after birth. To evaluate the effects of prenatal therapy, we collected serum samples and measured the acylcarnitine profiles using high-performance liquid chromatography electrospray ionization tandem mass spectrometry. At birth, levels of propionylcarnitine and 3-hydroxyisovalerylcarnitine had already increased. At 2 h after birth, these levels of acylcarnitines were further increased. At 3.5 h after the start of biotin, these chemical findings were slightly improved. In conclusion, we considered that prenatal biotin therapy at 10 mg/day may have been inadequate to avoid neonatal acidotic crisis in this case.
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U2 - 10.1016/j.braindev.2008.12.016
DO - 10.1016/j.braindev.2008.12.016
M3 - Article
C2 - 19201116
AN - SCOPUS:70350169096
SN - 0387-7604
VL - 31
SP - 775
EP - 778
JO - Brain and Development
JF - Brain and Development
IS - 10
ER -