A Pittsburgh woman has become the first documented case in a human of an untypical condition where alcohol naturally infuses in the bladder from yeast fermentation.
The condition, which experts propose to call either ‘urinary auto-brewery syndrome’ or ‘bladder fermentation syndrome’, is similar to another super rare ailment, auto-brewery syndrome, where merely consuming carbohydrates can be enough to make you intoxicated, even without ingesting any alcohol via ordinary means. In the most recent case, physicians became aware of what appears to be a related syndrome, after treating a 61-year-old patient who had poorly maintained diabetes and liver damage.
The woman frequented UPMC Shadyside for placement on a waitlist for a liver transplant, with physicians having previously suspected her issues stemmed from addiction to alcohol, as a result of repeated urine tests testing positive for alcohol “Initially, our encounters were similar, leading our clinicians to believe that she was hiding an alcohol use disorder,” explained in a new case report by her doctors. “However, we noted that plasma test results for ethanol and urine test results for ethyl glucuronide and ethyl sulfate, which are the metabolites of ethanol, were negative, whereas urine test results for ethanol were positive.”
Moreover, in addition to consistently refuting having drunk alcohol, the woman did not seem to display signs of inebriation during trips to the clinic. “The experience we describe here of two liver transplant teams at different institutions demonstrates how easy it is to overlook signals that urinary auto-brewery syndrome may be present,” say the doctors. “Clinicians must be diligent about paying close attention to medical record documentation and laboratory results and should always investigate in the event of incongruences.”
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