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Patient smells like putrid fish
    Differential Diagnosis[Top] [Nav]
trimethylaminuria
    Discussion -- not available online[Top] [Nav]
    Update Comments[Top] [Nav]
  • Identifies the gene for trimethylaminuria. [105]
  • Asians and "Eskimos" who subsist largely on fish may smell like fish. [109]
  • "High-dose fish oil consumption is associated with patients exuding a strong fish aroma." [110]
  • "Some patients with keratoderma have a very fishy odour which they find distressing, as do people in the immediate environment." [111]
  • Mentions that anosmias for fishy and sweaty odors exist. ???1265-9,1339,1337-43???? [112]
  • Humorist's column referring to article by P. Ole Fanger in the Journal of the American Society for Heating, Refrigeration and Air-Conditioning Engineers. That article delineates the many sources of smells emanating from the human body. [113]
  • 3% of patients taking sodium phenylbutyrate, an orphan drug used for treatment of urea-cycle disorders such as ornithine transcarbamylase deficiency, develop an offensive body odor. It is attributed to a metabolite, phenylacetate, which has "an extremely disagreeable odor and unpleasant taste." No mention if the odor is fishy or not. [114]
    Footnotes in Print Edition[Top] [Nav]
    (1) Trimethylaminuria.
  Brewster MA, Schedewie H.   Ann Clin Lab Sci 1983 Jan-Feb;13(1):20-4.  Pubmed+Abstract  Similars
    (2) The fish odor syndrome. Trimethylaminuria.
  Shelley ED, Shelley WB.   JAMA 1984 Jan 13;251(2):253-5.  Pubmed  Similars
    (3) Biochemical profile or uremic breath.
  Simenhoff ML, Burke JF, et al.   N Engl J Med 1977 Jul 21;297(3):132-5.  Pubmed+Abstract  Similars
    (4) The Whole Emergency Medicine Catalog.
  Jastremski MS, et al. Philadelphia: Saunders, 1985: 16-17.
    (5) Medical Knowledge Self-Assessment Program VII.
  American College of Physicians. Philadelphia: American College of Physicians, 1985: 27, 164.
    New References[Top] [Nav]

Trimethylaminuria
    101.Fish-odor syndrome: an olfactory diagnosis.
  Ruocco V, Florio M.   Int J Dermatol 1995 Feb;34(2):92-3.  Pubmed  Similars
    102.Exacerbation of symptoms of fish-odour syndrome during menstruation [letter].
  Zhang AQ, Mitchell SC, et al.   Lancet 1996 Dec 21-28;348(9043):1740-1.  Pubmed  Similars
    103.Trimethylaminuria in a girl with Prader-Willi syndrome and del(15)(q11q13).
  Chen H, Aiello F.   Am J Med Genet 1993 Feb 1;45(3):335-9.  Pubmed+Abstract  Similars
    104.The fish odour syndrome: biochemical, familial, and clinical aspects [see comments].
  Ayesh R, Mitchell SC, et al.   BMJ 1993 Sep 11;307(6905):655-7.  Pubmed+Abstract  Similars
    105.Missense mutation in flavin-containing mono-oxygenase 3 gene, FMO3, underlies fish-odour syndrome.
  Dolphin CT, Janmohamed A, et al.   Nat Genet 1997 Dec;17(4):491-4.  Pubmed+Abstract  Similars

Vaginitis
    106.Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations.
  Amsel R, Totten PA, et al.   Am J Med 1983 Jan;74(1):14-22.  Pubmed+Abstract  Similars
    107.Evaluation and management of vaginitis. An update for primary care practitioners.
  McCue JD.   Arch Intern Med 1989 Mar;149(3):565-8.  Pubmed+Abstract  Similars
    108.Semen and the vaginal fish odor [letter].
  Gordon N.   Am Fam Physician 1995 Aug;52(2):374.  Pubmed  Similars

Other causes of fishy smell
    109.The use of smell in differential diagnosis.
  Smith M, Smith LG, et al.   Lancet 1982 Dec 25;2(8313):1452-3.  Pubmed  Similars
    110.Fish oil therapy for ulcerative colitis shows promise, but it has an odoriferous downside.
  Baker B.   Int News & Cardiol News. 15 November 1993;5.
    111.The nose in diagnosis [letter].
  Cotterill JA.   Lancet. 1983;I:292-293.

Miscellany
    112.Taste and smell in disease (first of two parts).
  Schiffman SS.   N Engl J Med 1983 May 26;308(21):1275-9.  Pubmed  Similars
    113.Here's medical news to shock and amuse.
  Barry D.   Dallas Morning News. 15 January 1989, page 10F.
    114.Sodium phenylbutyrate for urea cycle enzyme deficiencies.
  Med Lett Drugs Ther 1996 Nov 22;38(988):105-6.  Pubmed  Similars
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    ©1986-2000 John Sotos, MD. All rights reserved.  Last updated 16:34 PDT on July 4, 2000.[Top]

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