Due to the acute and fulminant initial presentation, treatment will almost certainly be initiated in the hospital. Once treatment has begun and the acute signs and symptoms have disappeared, the child may be safely discharged and followed as an outpatient. No dietary restrictions are needed. No restriction is necessary. Essential coenzyme - Biotin is a coenzyme for 4 carboxylases.
Daily administration is essential for maintenance of metabolic equilibrium.
Closely follow growth and development to attend to any residual morbidity resulting from the initial insult. Prolonged failure of adherence to daily biotin requirement will result in insidious onset of the underlying disease with potential life-threatening consequences. Early and consistent treatment will allow excellent prognosis. Teenaged patients often will rebel against taking daily medication despite the fact that biotin itself is odorless, tasteless, and given as a capsule. Multiple carboxylase defects and complementation studies with propionicacidemia in cultured fibroblasts.