Microbes of Autobrewery Syndrome

Auto-Brewery Syndrome (ABS), also known as gut fermentation syndrome (GFS), is an unusual condition that causes elevated levels of alcohol in the blood and symptoms of alcohol intoxication, even in patients who have had little to no alcohol intake. This can lead to failed breathalyzer tests, neurocognitive disturbances, and social and legal consequences for those affected. Our earlier studies showed that the majority of MEBO and PATM sufferers, representing a subtype of this condition, have at least a mild form of this syndrome (elevated alcohol in sugar challenge test). 

Recent research has shed new light on the gut microbiome's role in ABS, highlighting it as a disorder of dysbiosis and showing the potential for targeted interventions that address the underlying microbial imbalances associated with the condition. 

A 58 years old female presented with mild cognitive impairment, behavioral disturbances, and recurrent encephalopathy episodes. The history of hemicolectomy, an odd smell on her breath, and cravings for high carbohydrate meals during the paroxysmal episodes raised the suspicion of ABS. Her blood ethanol concentration reached 315 mg/dL following an oral glucose tolerance test (OGTT), and stool analysis revealed increased colonization with C. krusei and C. parapsilosis. She was free of the acute episodes, cognitive and behavioral disturbances improved, and C. krusei and C. parapsilosis were eliminated from the intestinal flora with dietary recommendations and nystatin treatment.


REFERENCES

Ser MH, Çalıkuşu FZ, Erener N, Destanoğlu O, Kıykım E, Siva A. Auto brewery syndrome from the perspective of the neurologist. J Forensic Leg Med. 2023 Mar 28;96:102514. doi: 10.1016/j.jflm.2023.102514. Epub ahead of print. PMID: 37004374.

Irene S. Gabashvili Community-led research discovers links between elusive symptoms and clinical tests 2017 bioRxiv 139014; doi: https://doi.org/10.1101/139014

Irene S. Gabashvili Identifying subtypes of a stigmatized medical condition 2019 medRxiv 19005223; doi: https://doi.org/10.1101/19005223

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