Functions

Coenzyme for various carboxylase enzyme complexes, which all add a 1-carbon group

  • Fatty acid synthesis: acetyl-CoA carboxylase
    • Acetyl-CoA (2C) → malonyl-CoA (3C)
  • Gluconeogenesis: pyruvate carboxylase
    • Pyruvate (3C) → oxaloacetate (4C)
  • Fatty acid reduction: propionyl-CoA carboxylase
    • Propionyl-CoA (3C) → methylmalonyl-CoA (4C)

Tip

Biotin is a coenzyme in all carboxylase enzyme complexes that are not vitamin K-dependent.


Epidemiology


Etiology

  • Malnutrition
  • Prolonged use of antibiotics (destruction of intestinal flora)
  • Excessive consumption of raw egg white: contains avidin → binds biotin in the intestinal lumen → inhibition of biotin resorption
    • Like most proteins, avidin is heat-sensitive and loses this characteristic when cooked.

Pathophysiology


Clinical features

  • Dermatitis
  • Conjunctivitis
  • Enteritis
  • Alopecia
  • Myalgia
  • Neurological symptoms: lethargy, depression, mental status changes, hallucinations, paresthesia

Diagnostics


Treatment