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The classic symptoms of holocarboxylase synthetase deficiency are hypotonia, lethargy, seizures, metabolic acidosis, vomiting, hyperammonemia, developmental delay, skin rash, and alopecia

But in August, FDA rejected filgotinib due to concerns regarding the safety of its high dose

Consider imaging studies for sudden hearing loss or other red flags

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Conversely, if blood pressure remains elevated despite Ozempic therapy and lifestyle measures, intensification of antihypertensive treatment may still be necessary

ACKNOWLEDGMENTS AND DISCLOSURES The study was supported by the Alexander von Humboldt Foundation (E.P.)