Doctors tried to treat a woman looking for a liver transplant for addiction after results showed her urine was full of alcohol.
The problem: She denied ever drinking a drop.
Medical professionals at the University of Pittsburgh School of Medicine discovered that the 61-year-old woman wasn’t trying to hide an alcohol-use disorder but had a rare medical condition called auto-brewery syndrome, or ABS.
In a case study published in the peer-reviewed Annals of Internal Medicine, doctors said yeast in her bladder fermented sugar to produce ethanol because of “poorly controlled” diabetes. They proposed calling the phenomenon “urinary auto-brewery syndrome” or “bladder fermentation syndrome.”
The study’s authors made the distinction from traditional auto-brewery syndrome, also known as gut fermentation syndrome, because patients with this medical condition produce alcohol in their gastrointestinal system.
Patients with traditional ABS usually have alcohol in their blood or present symptoms of intoxication; however, the woman didn’t present any of these symptoms since her bladder produced the alcohol.
Traditional ABS causes the carbohydrates one ingests to turn into alcohol, fermented by fungi or bacteria in the gastrointestinal system. Cases were first documented in Japan in the 1970s, then in the USA 10 years later, according to researchers.
Doctors noted that no standard exists for diagnosing and treating gut fermentation syndrome, but a combination of “dietary modifications, appropriate antifungal therapy and possibly probiotics” should be studied as a possible treatment.
After unsuccessfully trying to get rid of the yeast using an antifungal regimen, the woman diagnosed with urinary ABS is being considered for a liver transplant.
Kenichi Tamama, medical director of the University of Pittsburgh Medical Center's Clinical Toxicology Laboratory and associate professor of pathology at the UP School of Medicine, said he's glad his team went the extra mile to correctly diagnose this patient.
"I’m happy to demystify the situation, and that’s helpful to her because this alcohol abuse diagnosis has been haunting her," he said.
He hopes this discovery will bring awareness to the medical community and help other patients who may suffer from this rare condition but are labeled as people with an alcohol-use disorder.
The University of Pittsburgh School of Medicine said the patient declined to give any details on her current condition.
Contributing: Ryan Miller
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT