Urinary Auto-brewery Syndrome: A Case Report
Authors: Katherine M. Kruckenberg, Andrea F. DiMartini, Jacqueline A. Rymer, A. William Pasculle, Kenichi Tamama
Journal: Annals of Internal Medicine (2020)

Letters19 May 2020Urinary Auto-brewery Syndrome: A Case ReportKatherine M. Kruckenberg, BA, Andrea F. DiMartini, MD, Jacqueline A. Rymer, BS, MT (ASCP), A. William Pasculle, ScD, and Kenichi Tamama, MD, PhDKatherine M. Kruckenberg, BAUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (K.M.K., A.F.D.)Search for more papers by this author, Andrea F. DiMartini, MDUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (K.M.K., A.F.D.)Search for more papers by this author, Jacqueline A. Rymer, BS, MT (ASCP)Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania (J.A.R.)Search for more papers by this author, A. William Pasculle, ScDClinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (A.W.P.)Search for more papers by this author, and Kenichi Tamama, MD, PhDClinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, University of Pittsburgh School of Medicine, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania (K.T.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0661 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Auto-brewery syndrome is 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 (1).Objective: To alert clinicians to the possibility of a previously unrecognized auto-brewery syndrome in which ethanol is produced through endogenous fermentation in the urinary system.Case Report: A 61-year-old woman with cirrhosis and poorly controlled diabetes presented to our center for placement on the liver transplant waitlist. Previously, clinicians at another hospital advised her to obtain treatment for alcohol addiction instead of placing her on their center's liver transplant ...References1. Logan BK, Jones AW. Endogenous ethanol ‘auto-brewery syndrome' as a drunk-driving defence challenge. Med Sci Law. 2000;40:206-15. [PMID: 10976182] CrossrefMedlineGoogle Scholar2. Hannuksela ML, Liisanantti MK, Nissinen AE, et al. Biochemical markers of alcoholism. Clin Chem Lab Med. 2007;45:953-61. [PMID: 17579567] CrossrefMedlineGoogle Scholar3. Gruszecki AC, Robinson CA, Kloda S, et al. High urine ethanol and negative blood and vitreous ethanol in a diabetic woman: a case report, retrospective case survey, and review of the literature. Am J Forensic Med Pathol. 2005;26:96-8. [PMID: 15725786] CrossrefMedlineGoogle Scholar4. Tam P, Gee K, Piechocinski M, et al. Candida glabrata, friend and foe. J Fungi (Basel). 2015;1:277-92. [PMID: 29376912] doi:10.3390/jof1020277 CrossrefMedlineGoogle Scholar5. Dimartini AF, Dew MA. Monitoring alcohol use on the liver transplant wait list: therapeutic and practical issues [Editorial]. Liver Transpl. 2012;18:1267-9. [PMID: 22887916] doi:10.1002/lt.23529 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (K.M.K., A.F.D.)Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania (J.A.R.)Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (A.W.P.)Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, University of Pittsburgh School of Medicine, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania (K.T.)Acknowledgment: The authors thank the Special Chemistry Laboratory staff for their technical support.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0661.This article was published at Annals.org on 25 February 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEndogenous Ethanol and Triglyceride Production by Gut Pichia kudriavzevii, Candida albicans and Candida glabrata Yeasts in Non-Alcoholic SteatohepatitisOral form of auto-brewery syndromeFalse-Positive Ethanol Level in Urine and Plasma Samples of a Resuscitated InfantThe Auto-Brewery Syndrome: A Perfect Metabolic “Storm” with Clinical and Forensic ImplicationsGut fermentation syndrome: A systematic review of case reportsAuto‐brewery syndrome caused by oral fungi and periodontal disease bacteriaCase Report: Diabetic urinary auto-brewery and review of literatureFactors in an Auto-Brewery Syndrome group compared to an American Gut Project group: a case-control studyEthanolémie positive sans consommation d’alcool chez le sujet vivant : le syndrome d’auto-brasserie. Conséquences cliniques et médico-judiciaires 19 May 2020Volume 172, Issue 10Page: 702-704KeywordsAlcoholismAlcoholsBladderBlood plasmaEthanolIntoxicationLiver transplantationResearch laboratoriesSodiumUrine ePublished: 25 February 2020 Issue Published: 19 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...