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Related Experiment Videos

Trimethylamine and foetor hepaticus.

S Mitchell1, R Ayesh, T Barrett

  • 1Molecular Toxicology, Division of Biomedical Sciences, Imperial College School of Medicine, London, England.

Scandinavian Journal of Gastroenterology
|July 28, 1999
PubMed
Summary

Patients with liver disease may experience unusual body odors due to elevated trimethylamine (TMA) levels. This study investigated TMA in urine, finding significant amounts in many patients, potentially causing a "fish-odor syndrome".

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Area of Science:

  • Hepatology
  • Clinical Chemistry
  • Metabolic Disorders

Background:

  • Hepatocellular failure and portosystemic shunting can cause foetor hepaticus.
  • Unusual body odours are common in liver disease patients.
  • Trimethylamine (TMA) is implicated in fish-odour syndrome.

Purpose of the Study:

  • To investigate the role of excessive trimethylamine (TMA) in body odours associated with hepatic disease.
  • To determine TMA levels in patients with various liver diseases.

Main Methods:

  • Collected 24-hour urine samples from 63 patients with confirmed liver diseases.
  • Measured total trimethylamine and trimethylamine N-oxide levels using head-space gas chromatography.

Main Results:

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  • 50% of patients (32/63) had elevated urinary TMA levels.
  • 17 patients excreted high levels of free TMA (>10 microg/ml), exceeding the threshold for fish-like odour.
  • Elevated TMA was observed in both primary (53.2%) and secondary (43.8%) liver disease.

Conclusions:

  • Excessive trimethylamine (TMA) likely contributes to body odour issues in severe hepatic disease.
  • Patients with liver disease may develop a secondary fish-odour syndrome due to elevated TMA.