The Week That Wasn't: Bladder Brewery, Mouse Diabetes Cure, Brain Trauma Tests

Ellie Kincaid


February 28, 2020

You may have recently seen articles about a woman with diabetes whose bladder was home to alcohol-producing yeast, a stem cell–based cure for diabetes in mice, and new tests that could help diagnose brain trauma in veterans who have experienced improvised explosive device (IED) blasts. Here's why you didn't see them on Medscape Medical News

A Brewing Bladder

Physicians and scientists at the University of Pittsburgh School of Medicine in Pennsylvania coined a new medical term, "urinary autobrewery syndrome," to describe the case of a 61-year-old woman with cirrhosis and diabetes whose urine tested positive for ethanol despite her denials that she consumed alcohol.

The woman needed a liver transplant, but clinicians suspected she was hiding alcohol use disorder and wouldn't put her on the waitlist for an organ. Only after noticing discrepancies in her labs — her blood tested negative for ethanol — and running further tests on her urine did physicians discover the strange truth. The yeast Candida glabrata living in her bladder was fermenting the sugar in her urine. With those results, they reconsidered her for liver transplantation.

The physicians' takeaway, as they wrote in a case report in the Annals of Internal Medicine: "Clinicians must be diligent about paying close attention to medical record documentation and laboratory results and should always investigate in the event of incongruences."

The authors also note they have not found another similar report in the medical literature. Rare, fascinating cases like this one do grab eyeballs, but we didn't think we needed to use our readers' time to tell them about a medical condition that most are unlikely to see.

Lab Mice Cured of Diabetes

Mice with severe diabetes had their disease reversed after they received transplants of insulin-producing pancreatic beta cells made from human pluripotent stem cells, according to a report in the journal Nature Biotechnology. The animals maintained normal blood glucose levels for at least 9 months post-transplant.

Preclinical work like this is essential to developing new treatments for patients, but if it's only in mice, it's generally too early stage for clinicians to care about. We didn't think our readers needed to hear about this research quite yet.

Testing for Brain Trauma

Although physicians can suspect a patient may have chronic traumatic encephalopathy from repeated mild traumatic brain injury (mTBI), there currently isn't a test to confirm this diagnosis before death. To investigate potential diagnostic biomarkers, researchers at the Icahn School of Medicine at Mount Sinai in New York City tested the blood and scanned the brains of a group of 10 veterans who had been exposed to IED blasts, met diagnostic criteria for mTBI, and reported behavioral and cognitive symptoms such as depression and headaches.

In half the group, researchers found signs of the protein tau in the veterans' brains and the neurofilament light chain protein in their blood samples.

The researchers write that "further study is required to determine whether clinical, neuroimaging, and/or fluid biomarker signatures can improve the diagnosis of long-term neuropsychiatric sequelae of mTBI" — so their methods are not ready for primetime in patient care yet. Until they are, they're not relevant to our readers, so we didn't think it was necessary to cover this research.

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