The Curious Case of the Woman Who Urinates Alcohol

Intestinal Fermentation Syndrome, or Auto-Brewery Syndrome is an unusual condition that produces significant amounts of ethanol through an endogenous fermentation process in the digestive system. In other words, the body gets drunk by itself due to the presence of a type of yeast in the intestine. However, a medical team from the University of Pittsburgh detected a variant of that syndrome that made a woman urinate alcohol...

The story tells that a 61-year-old diabetic woman (whose name has not been disclosed until now) approached the University of Pittsburgh Medical Center seeking a liver transplant, after another institution rejected her request due to “problems with alcohol” The center's authorities placed her on the list, and at the same time indicated the start of treatment for her addiction.

The Mystery

The main conflict was that the woman insisted she had not drunk a single drop of alcohol, but all her urine tests came back positive. The case reached the hands of psychiatrist Andrea DiMartini, who requested the latest laboratory tests of the patient. The doctors noted that the urine kept testing positive (with the laboratory equipment highlighting an intense smell “similar to wine” in the samples), but the blood tests came back negative. What was happening?

The Explanation

When the human body metabolizes alcohol, its elimination is faster in the blood. Furthermore, if the patient had a serious problem with drinking, her urine should contain two metabolites of alcohol, ethyl glucuronide (EtG) and sulfovinic acid. The metabolites never appeared in the tests, and another striking detail is that the patient never showed signs of intoxication.

As if that were not enough, the analyses revealed an additional mystery: Hyperglycosuria, which describes very high levels of glucose in the urine... and the presence of yeast. The yeast in question was identified as Candida glabrata, which occurs naturally in the human body, but also behaves as an opportunistic pathogen in immunodeficient patients.

The Conclusion

The doctors' conclusion was that the hyperglycosuria was a product of her uncontrolled diabetes, and a colony of Candida glabrata installed in her bladder was fermenting the sugar in the urine. The result... alcohol. Unfortunately, the treatment to eliminate the yeast failed (her diabetes would be the main suspect), and the original report does not say what happened to the patient in the end, but beyond its rarity, the doctors recognize that the case forces establishing new parameters for alcohol detection in urine, addiction treatments, and transplant programs.

Source: International Business Times