{"id":"3627626b-81df-515b-9fe7-fa5a9341afd4","stable_key":"08ce9896-9d1c-5bbf-b705-5bfe771091d5:b7-combined-b2-b7","predicate":"combined_deficiency_associated_with","statement":"Premature twins on vitamin-limited parenteral nutrition developed severe illness associated with B2/B7 deficiency; the surviving twin improved after both vitamins were supplied.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"08185526-2d6d-5571-b03c-8368d8574625","mechanism_event_label":"The case illustrates interacting shortages, without identifying which vitamin caused each finding.","subject":{"id":"37a8e96b-f95b-5ba7-a0bc-8ed3cfaf5fd8","slug":"biotin","display_name":"Biotin","entity_type_key":"small_molecule"},"object":{"id":"53311fa8-f17b-5914-8276-b9f94ecc9700","slug":"preterm-combined-b2-b7-deficiency","display_name":"Clinical findings in combined B2 and B7 deficiency in preterm infants","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"08185526-2d6d-5571-b03c-8368d8574625","stable_key":"08ce9896-9d1c-5bbf-b705-5bfe771091d5:b7-combined-b2-b7-event","event_type":"observed_intervention","label":"The case illustrates interacting shortages, without identifying which vitamin caused each finding.","description":"Premature twins on vitamin-limited parenteral nutrition developed severe illness associated with B2/B7 deficiency; the surviving twin improved after both vitamins were supplied.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"86eb1eee-a8d1-539c-8c17-0911f69b6f1b","slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"},"role":"co-deficient nutrient","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"37a8e96b-f95b-5ba7-a0bc-8ed3cfaf5fd8","slug":"biotin","display_name":"Biotin","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"53311fa8-f17b-5914-8276-b9f94ecc9700","slug":"preterm-combined-b2-b7-deficiency","display_name":"Clinical findings in combined B2 and B7 deficiency in preterm infants","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/biotin-research/37085971.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"981b9e33d62aaeda20905c76b8da3a96b2d5d8184a707beed7de5f66498974b5\", \"start_char\": 0, \"end_char\": 1081, \"text_sha256\": \"981b9e33d62aaeda20905c76b8da3a96b2d5d8184a707beed7de5f66498974b5\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Case report of extremely premature twins during a parenteral multivitamin shortage","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Combined B2 and B7 deficiency on prolonged parenteral nutrition","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Two highly vulnerable infants and multiple concurrent problems; improvement after combined treatment cannot be attributed to biotin alone.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Biotin research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"biotin","display_name":"Biotin","entity_type_key":"small_molecule"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The case illustrates interacting shortages, without identifying which vitamin caused each finding.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[b7-p37085971] Twin Premature Infants With Riboflavin and Biotin Deficiency Presenting With Refractory Lactic Acidosis, Rash, and Multiorgan Failure During Prolonged Parenteral Nutrition. (2023). https://pubmed.ncbi.nlm.nih.gov/37085971/ DOI: 10.1177/23247096231168111","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Multisystem neonatal illness","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"50b029ad-0ead-5d5c-acc5-26d8426599d7","evidence_kind":"source_excerpt","locator":"Lines 1040-1051","start_line":1040,"end_line":1051,"excerpt":"### b7-combined-b2-b7\nPremature twins on vitamin-limited parenteral nutrition developed severe illness associated with B2/B7 deficiency; the surviving twin improved after both vitamins were supplied.\nCondition category: nutrient_deficiency\nnutrient_topic: Biotin research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The case illustrates interacting shortages, without identifying which vitamin caused each finding.\norganism: Homo sapiens\ntissue_or_cell_type: Multisystem neonatal illness\nexperimental_model: Case report of extremely premature twins during a parenteral multivitamin shortage\nlimitations: Two highly vulnerable infants and multiple concurrent problems; improvement after combined treatment cannot be attributed to biotin alone.\nexposure: Combined B2 and B7 deficiency on prolonged parenteral nutrition\nevidence_span: {\"source_cache\": \"artifacts/biotin-research/37085971.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"981b9e33d62aaeda20905c76b8da3a96b2d5d8184a707beed7de5f66498974b5\", \"start_char\": 0, \"end_char\": 1081, \"text_sha256\": \"981b9e33d62aaeda20905c76b8da3a96b2d5d8184a707beed7de5f66498974b5\"}\n[b7-p37085971] Twin Premature Infants With Riboflavin and Biotin Deficiency Presenting With Refractory Lactic Acidosis, Rash, and Multiorgan Failure During Prolonged Parenteral Nutrition. (2023). https://pubmed.ncbi.nlm.nih.gov/37085971/ DOI: 10.1177/23247096231168111","model_system":"Case report of extremely premature twins during a parenteral multivitamin shortage","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [b7-p37085971] Twin Premature Infants With Riboflavin and Biotin Deficiency Presenting With Refractory Lactic Acidosis, Rash, and Multiorgan Failure During Prolonged Parenteral Nutrition. 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