Auto-brewery syndrome: Ethanol pseudo-toxicity in diabetic and hepatic patients

Hafez, E M; Hamad, MA Soliman; Fouad, Magdy; Abdel‐Lateff, Ahmed

doi:10.1177/0960327116661400

Cited by 39 publications

(48 citation statements)

References 20 publications

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“…It has also been postulated that reduced activity of enzymes responsible for ethanol metabolism in the liver which may be genetically linked could be responsible for this syndrome [2]. Endogenous alcohol production has also been shown to increase in patients with diabetes mellitus and cirrhosis [7]. Our patient has type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 78%

A Case of Auto-brewery Syndrome Treated with Micafungin

Saverimuttu¹,

Malik²,

Arulthasan³

et al. 2019

Cureus

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Auto-brewery syndrome is caused by alcohol brewing inside the human body; it is a rare clinical condition where the patient becomes inebriated without exogenous alcohol use. Yeast is responsible, and treatment requires an appropriate antifungal agent. If undiagnosed, the patient's life becomes a misery. We present a case of a 45-year-old male who suffered from this condition for over three years with two arrests for driving under the influence prior to being diagnosed. The patient stated that he felt the episodes were related to his meal intakes; therefore, he would skip most meals of the day. The patient visited several centers where he was told there was not much they could offer him and he was left without a diagnosis. A carbohydrate challenge test in a monitored setting showed elevated blood alcohol levels. He was treated with antifungals and a low carbohydrate diet which resulted in the resolution of his symptoms. Hence the importance of awareness among physicians is necessary along with a high index of suspicion.

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Section: Discussionmentioning

confidence: 78%

A Case of Auto-brewery Syndrome Treated with Micafungin

Saverimuttu¹,

Malik²,

Arulthasan³

et al. 2019

Cureus

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“…Auto-brewery syndrome (ABS), also known as Gut Fermentation Syndrome and Endogenous Ethanol Fermentation, has long been recognized in the literature. The earliest cases were reported in Japan in the 1950s to 1970s 1–3 and continue to be documented, researched, and reported into the current century not only in Japan but also in Great Britain, 4–6 Egypt, 7 and the United States. 8,9 In 2016, authors from the Mayo Clinic stated “… auto-brewery may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake.” 10 Despite the many articles describing the syndrome, relatively little is known about the underlying mechanisms, let alone the cause.…”

Section: Introduction and Review Of Literaturementioning

confidence: 97%

Case–Control Research Study of Auto-Brewery Syndrome

Cordell

Kanodia

Miller

2019

Glob Adv Health Med

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Background Auto-brewery syndrome (ABS), also known as Gut Fermentation Syndrome and Endogenous Ethanol Fermentation, is afflicting people worldwide, but little is known about ABS patients’ demographics, health history, lifestyle factors, and diet. Method We conducted a broad-based case–control survey study on 52 patients known to have a diagnosis of ABS and their household members. The research compares the symptomatic group (N = 28) to the asymptomatic group (N = 18) regarding lifestyle and health, diet, and medical history. Results With a response rate of 88% and using rank-sum tests, the data demonstrate that patients with ABS have significant differences compared to people without ABS in lower quality bowel movements ( P = .048), more frequent bowel movements ( P = .038), more reports of malodorous breath ( P = .0001), and self-classify as having poorer health ( P = .009). Furthermore, participants with ABS consume more water ( P = .038), consume less tea and coffee ( P = .033), eat fewer dairy products ( P = .0185), eat less candy ( P = .032), eat out less and rely on food prepared at home ( P = .043), have more aversion to starch ( P = .008), and have more food sensitivities ( P = .043) than the group without ABS. The ABS group also reports more diarrhea ( P = .048), higher amounts of yeast in their gastrointestinal tract ( P = .015), and using acne medication for a longer time ( P = .037) than the control group. Conclusion Patients with ABS have significant differences in their lifestyle and health, diet, and medical history compared to non-ABS participants and these differences warrant further research.

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“…However, besides analytical challenges when evaluating the zero alcohol limit, endogenous ethanol production which does not originate but is related to spontaneous production by different metabolic pathways and patients suffering from various metabolic disorders ( e.g., diabetes, cirrhosis) should also be considered ( 19 , 20 ). In a large study of alcohol-free healthy individuals, mean BEC of 0.01 ± 0.04 g/L and a maximum blood ethanol concentration 0.15 g/L was reported using sensitive headspace GS/MS ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Measurement uncertainty of blood ethanol concentration in drink-driving cases in an emergency laboratory

Üstündağ

Huysal

2017

Biochemia Medica

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IntroductionThe quality of blood ethanol concentration (BEC) determination is important because of its legal ramifications. Measurement uncertainty provides quantitative information about the quality and reliability of test results. In this study, we aim to calculate the measurement uncertainty for the ethanol test in our laboratory measured with a Synchron Systems Ethanol assay kit by employing an enzymatic rate method on the Beckman-Coulter Olympus AU400 auto analyzer (Beckman Coulter Inc, Melville, USA).Materials and methodsThe measurement uncertainty values were calculated in accordance to the Nordtest guidelines. All vehicle drivers involved in a traffic accident were retrospectively inspected for the BEC test conducted during July to December 2016 in our emergency laboratory.ResultsA 1034 vehicle drivers had their BEC tested. The results for 181 drivers were > 0.50 g/L and reported as positive. The serum ethanol concentration in those showing a positive result was 2.04 ± 1.01 g/L, over four times the legal limit. The median BEC in those showing a negative result was 0.03 (IQR: 0.03) g/L. The expanded uncertainty obtained was 19.74%. When measurement uncertainty values were added to the results of the 1034 drivers who were retrospectively screened, eight vehicle drivers had results with 95% confidence intervals that exceeded the legal limit 0.50 g/L.ConclusionsThe BEC test results for vehicle drivers with values close to legal limits should be reported as the obtained ethanol concentration with corresponding measurement uncertainty.

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Auto-brewery syndrome: Ethanol pseudo-toxicity in diabetic and hepatic patients

Cited by 39 publications

References 20 publications

A Case of Auto-brewery Syndrome Treated with Micafungin

A Case of Auto-brewery Syndrome Treated with Micafungin

Case–Control Research Study of Auto-Brewery Syndrome

Measurement uncertainty of blood ethanol concentration in drink-driving cases in an emergency laboratory

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