Woman denied spot on liver transplant list until rare bladder condition discovered

A woman was repeatedly kicked off liver transplant waiting lists after tests showed she abused alcohol until researchers discovered that her bladder was producing the alcohol, according to CNN.

The woman was placed on UPMC's liver transplant wait list and was almost kicked off again for suspected alcohol abuse, which she denied. UPMC clinicians decided to conduct a few more tests.

They found ethanol present in the patient's urine, but ethyl glucuronide or ethyl sulfate, the metabolites of ethanol, were not present. Had she been abusing alcohol, those metabolites would have been present.

Instead, the patient's urine had yeast and very high sugar, leading researchers to investigate whether the yeast was producing the alcohol. They found that this was the case.

The woman is the first proven case of urinary auto-brewery syndrome, where "a rare medical condition in which intoxicating quantities of ethanol are produced by specific types of yeast or bacteria through endogenous fermentation in the digestive system," researchers wrote in a study published in Annals of Internal Medicine.

Researchers also said that the patient's poorly controlled diabetes led to high sugar levels in her bladder, which interacted with the yeast to cause the fermentation.

This discovery is important for liver transplant clinics or alcohol abuse clinics, "because they're the ones that monitor alcohol abstinence," Kenichi Tamama, MD, PhD, medical director of the UPMC's clinical toxicology laboratory told CNN.

The clinics need to know that lab results for patients with urinary auto-brewery syndrome may be misconstrued, he said.


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