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Woman Denied Liver Transplant Revealed To Brew Alcohol In Her Bladder

Woman Denied Liver Transplant Revealed To Brew Alcohol In Her Bladder

She was initially denied a liver transplant because doctors thought she had been drinking

Jake Massey

Jake Massey

A woman in the US was found to brew alcohol in her bladder.

The 61-year-old went to hospital in Pittsburgh, Pennsylvania, to try and get on the waiting list for a liver transplant, as she had scarring of the liver (cirrhosis) and diabetes.

However, her urine tests kept testing positive for alcohol, leading doctors to believe she was hiding alcoholism, and therefore ineligible.

Doctors discovered that the woman had an extremely rare condition.

The woman repeatedly denied drinking and did not appear intoxicated - and then doctors at University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital made a curious discovery.

Urine tests for two metabolites of alcohol - ethyl glucuronide and ethyl sulfate - were negative for the woman, and ordinarily at least one of these would be present in someone who has been drinking.

Furthermore, she had high levels of glucose and yeast, leading doctors to wonder whether the microbes in her bladder were fermenting the sugar into alcohol.

A case report published last year in the journal Annals of Internal Medicine reads: "Initially, our encounters were similar, leading our clinicians to believe that she was hiding an alcohol use disorder.

"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.

"These findings led us to test whether yeast colonising in the bladder could ferment sugar to produce ethanol."

The answers lay in her urine samples.

To test the theory, they took a urine sample and put it on ice, before incubating it at body temperature. The result was 'remarkably high levels of ethanol production'.

The condition is similar to another extremely rare condition, auto-brewery syndrome, and doctors proposed to call it either 'bladder fermentation syndrome' or 'urinary auto-brewery syndrome'.

The woman was subsequently allowed to reapply for a liver transplant, and medics concluded that many other patients with the condition could have been overlooked in the past.

They said: "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.

"Clinicians must be diligent about paying close attention to medical record documentation and laboratory results and should always investigate in the event of incongruences."

Featured Image Credit: PA

Topics: Alcohol, Community, Weird, Health