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A 45-year-old woman suffers from the nauseating smell of sweat because it smells like rotten fish, a disorder that has poisoned her social life for more than 20 years. to eliminate it from her diet.
A newspaper report said:لوموندFrench (le monde), that the woman was sent for consultation at the University Hospital of Tours, but the clinical examination of this woman did not show any problems, which prompted the doctors to suggest – in this case – a different diagnosis, which is Fish Odor Syndrome, It is a relatively rare metabolic disorder that manifests itself in foul body odor.
The report pointed out that fish odor syndrome is also known as “trimethylaminuria”, which is a metabolic disorder related to the secretion of “trimethylamine”, the substance responsible for the unpleasant odor, and it is a recessive genetic disease (that is, the person must have A person has a gene from the father and a gene from the mother until the disease appears.
The role of genetics in diagnosis
The article touched on the method of diagnosis, which depends on measuring the amount of “trimethylaminuria” and “trimethyluria oxide” in the urine, and the most practical way is to make the patient take an adequate amount of trimethylol beforehand by eating 300 grams of marine fish, and given that the disorder It may be mild or intermittent, and it may be necessary to repeat the examination more than once for a diagnosis.
Fish odor syndrome was first reported in 1970
The report indicated that the first clinical description of this metabolic disorder, dating back to 1970, by James Hubert, University of Colorado, in an article published in the journal “The Lancet”, where this clinical case concerned a 6-year-old child, whose mother was smelling strange Sometimes it comes out. Although this metabolic disease is considered rare, more than 200 cases were reported in 2011.
The report goes back to the case of the 45-year-old woman stating that her case was reported by François Mayo and his fellow internists from the Regional University Hospital Center of Tours, France, and molecular biologists at the Regional University Hospital Center for Lille, in an article published in the March issue March 2022 from Journal of Internal Medicine.
Fish odor syndrome is a well-known disease, with significant psychological and social repercussions
The report shows that this disease usually appears in childhood or the beginning of adulthood, but it remains undiagnosed, especially since this rare disease is not well known to doctors due to the delay in diagnosis for several years, as confirmed by doctors at the Hospital Center of Tours. Due to the accumulation of trimethylaminuria due to diet and premenstrual syndrome, symptoms can be intermittent, which once more may contribute to a delay in diagnosis, which can create situations of long-term psychological distress.
Avoid certain foods
The report indicated that the treatment of this disease depends on the elimination of some products from the diet, especially foods rich in a food ingredient called choline, as it is absorbed by the small intestine, and excess choline is metabolized to methylamine by intestinal bacteria in the colon, and colon bacteria can also be generated. Also methylamine from lecithin, a substance found in some foods.
Foods rich in choline include skimmed milk, soybeans, fish, eggs, shrimp, chicken, nuts, peanuts, dried beans, peas, lentils, chocolate containing choline or lecithin, as well as foods containing soy lecithin.
The report shows that the 45-year-old patient was put on a de-choline diet, along with other treatments, which helped control her bad odor.
The report concluded by noting that a second case was recorded for a 70-year-old woman, in which doctors noticed a decrease in unpleasant odors following a diet low in choline, and other treatment, and all these measures made it possible to significantly improve the patient’s quality of life, who became able to Get out of her isolation and resume her social life.
