NBS-Biotinidase (BIOT) Test: Booking, Price, and Results
About NBS-Biotinidase (BIOT) Test: Booking, Price, and Results
| Find | Value |
|---|---|
| Also Known As | Biotinidase deficiency test, BIOT test, Biotinidase activity quantitative test, NBS Biotinidase |
| Sample Type | Dried blood spot (heel prick) for newborn screening; serum or plasma for confirmatory testing |
| Fasting Required | No |
| Report Time | 3 days |
| Recommended For | Newborns (as part of standard newborn screening); infants and children with suggestive symptoms |
| Price | Starting at ₹800 |
What is an NBS-Biotinidase (BIOT) Test?
The NBS-Biotinidase (BIOT) test measures the activity of the biotinidase enzyme in the blood. It is a standard part of newborn screening programmes and is used to detect biotinidase deficiency early in life. A small dried blood spot sample, collected by a heel prick, is used for screening, with serum or plasma used for confirmatory testing if needed.
What Does an NBS-Biotinidase (BIOT) Test Measure?
This test measures biotinidase enzyme activity in the blood. Biotinidase is an enzyme that recycles biotin, an important B vitamin needed for normal growth, metabolism, and other functions. The following explains what the test assesses.
| Parameter | What It Measures |
|---|---|
| Biotinidase enzyme activity | How well the body reuses biotin (Vitamin B7) |
| Percentage of normal activity | Classifies biotinidase deficiency as normal, partial (10 to 30% of normal), or profound (less than 10% of normal) |
When biotinidase activity is too low, the body cannot release free biotin. Free biotin is needed by several enzymes to break down fats, proteins, and carbohydrates for energy.
Why is an NBS-Biotinidase (BIOT) Test Done?
The BIOT test is done primarily as part of routine newborn screening. It may also be ordered when a baby or child shows certain symptoms. Here is a closer look at why a doctor may recommend it.
Common Symptoms That May Require This Test
A doctor may request this test if a child shows any of the following signs.
- Seizures or fits
- Weak muscle tone (hypotonia), where the baby feels unusually floppy
- Breathing difficulties
- Hearing or vision loss
- Problems with movement and balance (ataxia)
- Skin rashes
- Hair loss (alopecia)
Conditions This Test Can Help Detect
The NBS-Biotinidase (BIOT) test can help identify the following conditions.
- Profound biotinidase deficiency, where enzyme activity is less than 10% of the normal level
- Partial biotinidase deficiency, where enzyme activity falls between 10% and 30% of the normal level
- Multiple carboxylase deficiency, which occurs because several biotin-dependent enzymes are affected when biotin is insufficient
How to Prepare and What to Expect
No special preparation is needed for this test. Here is what parents should know before the sample is collected.
Do You Need to Fast?
No fasting is required. The BIOT test procedure is not affected by the baby's feeding schedule, so no changes to feeding routines are necessary.
Practical Tips Before Your Test
A few simple steps can help the sample collection go smoothly.
- Bring a detailed clinical history, including the baby's symptoms, previous test results, and family history, as this is required for the test
- Inform the healthcare provider of any medications the baby has received, particularly sulfonamide antibiotics, as these can interfere with the test
- If the baby has received a blood transfusion, tell the healthcare provider, as this can affect results; ideally, screen before any transfusion takes place
- Keep the baby calm and comfortable; feeding or cuddling before the heel prick can help
Step-by-Step Procedure
Here is what happens during a typical BIOT test procedure for a newborn.
- A trained healthcare professional gently pricks the baby's heel using a small, sterile device.
- A few drops of blood are collected and placed onto a special filter paper card (called a Guthrie card) to create dried blood spots.
- The spots are allowed to dry completely at room temperature before the card is packaged.
- The card is sent to a laboratory, where the sample is stored and transported at ambient temperature.
- In the laboratory, a machine measures the biotinidase enzyme activity in the dried blood using spectrophotometry.
- If the screening result is abnormal, a confirmatory test using a serum or plasma sample may be ordered.
Factors That Can Affect Accuracy
Several factors can influence the accuracy of results.
- Prematurity, which is responsible for approximately half of all false-positive results
- Improper drying of the blood spot, or placing the card in a plastic bag before it has dried
- Exposure of the sample card to more heat or humidity during storage or transit
- Delayed transport of the sample to the laboratory
- Recent blood transfusion, which may cause a falsely low (false-negative) result
- Sulfonamide antibiotics, which may cause falsely elevated readings
- Impaired liver function in the newborn
Understanding Your NBS-Biotinidase (BIOT) Test Results
Results should always be reviewed by a qualified doctor who is familiar with the child's full medical history. The table below shows general reference ranges used to interpret biotinidase enzyme activity.
| Parameter | Reference Range |
|---|---|
| Biotinidase Enzyme Activity | 5.0–10 nmol/min/mL (or 3.5–13.8 U/L); indicates normal enzyme function if within range |
| Normal | Greater than 30% of normal enzyme activity |
| Partial deficiency | 10–30% of normal enzyme activity |
| Profound deficiency | Less than 10% of normal enzyme activity |
Full-term newborns typically show 50 to 70% of mean normal adult biotinidase activity, so separate reference ranges may apply for this age group. Babies with partial deficiency may need repeat testing at three to six months of age to confirm results.
These ranges are general guidelines. Your doctor will interpret your results based on your child's age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can affect the results.
- Sometimes, premature babies without a true deficiency may also have abnormal results. That’s because enzyme levels can be naturally lower in an early or premature birth, so doctors take the baby’s gestational age into account before interpreting the result.
Liver problems can also affect the test and cause a false positive result. The doctor will keep this in mind when reviewing the report if the individual suspects liver disease.
How to Maintain Healthy Levels
If your baby's results are normal, no specific action is needed beyond routine follow-up. The following general points apply to children identified through screening.
- Attend all recommended follow-up appointments and specialist consultations
- Follow the treatment plan prescribed by your doctor
- Keep a record of test results and medical visits to share with healthcare providers at future consultations
Lupin Diagnostics NBS-Biotinidase (BIOT) Test Price and Home Collection
The BIOT test cost at Lupin Diagnostics starts at ₹800, and home sample collection is available for this test. A certified phlebotomist can visit your home to collect the dried blood spot sample.
| City | Approximate price(₹) |
|---|---|
| BHOPAL | 800 |
| CHENNAI | 800 |
| HYDERABAD | 800 |
| KOLKATA | 800 |
| NAVI MUMBAI | 800 |
| PUNE | 800 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
BIOT test online booking at Lupin Diagnostics is simple.
- Select the NBS-Biotinidase (BIOT) test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified blood collector, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
BIOT test home collection is available across multiple cities, making it convenient for parents of newborns. Samples are processed in NABL-accredited laboratories by trained professionals. Digital reports are accessible via email or WhatsApp once ready.
Frequently Asked Questions
The NBS-Biotinidase (BIOT) test measures the activity of the biotinidase enzyme in a newborn's blood. It is a standard part of most newborn screening programmes and is used to confirm a diagnosis of biotinidase deficiency. Early detection through screening allows treatment to begin before symptoms appear.
The test is usually performed on dried blood spots collected around the third day after birth, though the exact timing may vary slightly depending on hospital protocols. Some hospitals conduct the test before the baby is discharged.
An out-of-range result does not automatically mean your child has the condition. A confirmatory test using a serum or plasma sample is the next step after an abnormal screening result. Your doctor will guide you through the process and explain what the findings mean.
Premature babies may have abnormal results because they have lower amounts of enzymes at birth. Repeat testing in 3–6 months usually confirms the partial deficiency.
There are two types: profound deficiency, where enzyme activity is less than 10% of the normal level, and partial deficiency, where activity is between 10% and 30% of normal. Profound deficiency is generally associated with more serious symptoms if left untreated.
The heel prick used to collect the dried blood spot sample is brief and causes only minor, momentary discomfort. Feeding or cuddling your baby before and during the procedure can help keep them calm. Most babies settle quickly after the sample is taken.
NBS-Biotinidase (BIOT) Test: Booking, Price, and Results
