Keywords/concepts
Congenital Portosystemic Shunt (a 'liver shunt').A bypass of the liver by the body's circulatory system.
Example : a vein forms between intestine artery and systemic artery.
Common in dogs and cats.
In humans ? (unknown). Is it regardless mostly harmless and not detected ?
Madrid Hospital, 2019.
CPSS and TMAU ?
A Madrid Hospital took a look at 15 cases of CPSS in humans.
3 of them said they have TMAU.
After surgery to solve the CPSS (presumably cutting the rogue vein), 2 of them were pronounced 'cured' of TMAU.
How common might CPSS type TMAU be ?
Nobody knows.
Maybe little is known of CPSS in humans ?
One paper from a long time ago mentioned a baby with a Portal Shunt that's only problem was TMAU. Perhaps this inspired the researchers in this case.
It's another avenue for the TMAU community to discuss and explore, the concept of a Portal Shunt causing TMAU, which could be 'cured' (?) by surgery.
Full paper : Link
This study aimed to report three new cases of an association between two rare conditions, congenital portosystemic shunts (CPSS) and trimethylaminuria (TMAU), and the efficacy of endovascular closure of the CPSS for resolving TMAU. Between November 2014 and April 2017, 15 patients with CPSS were enrolled in this prospective study to assess the efficacy of percutaneous endovascular shunt closure. Three patients presented with clinical symptoms of TMAU that were confirmed by urine analysis of trimethylamine (TMA) and TMA n-oxide. One year after endovascular closure of the congenital portosystemic shunt, the same parameters were evaluated were obtained and the values were compared to the pretreatment values. The results indicated the disappearance of clinical symptoms of TMAU and normalization of the urine test parameters in two patients and no changes in one patient, who developed new portosystemic communications.
General links :
Wikipedia PSS
Radiology : CPSS
Pubmed : 1 case in 1997
![[Facebook Share]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_v3tgk-DKmb-caWWF6ZYv5ueOoM4QSYaOgweVtQDQKs5OsvLXqKe2XQfjpT7VsvdhEEXNbMCyXBdVcbCX78dc5cIPHipLc=s0-d){kind=small}
UK 
Spain 
5 comments:
Very interesting to see, that there can be different causes of TMAU2.
I think the 'official' meaning of TMAU2 is 'anything that is not genetic TMAU (TMAU1)' ... but in practice is almost always due to TMA overload.
Im wondring if ammonia analyses would be a good thing to check before I go to a doctor duo this if ammonia way high too it could be a sign right ?
I had a gastric bypass in 1990 and subsequent reversal the next year due to complications. Years later After ending up with multiple injuries and c sections etc one after the other I was on narcotics for about 6 years. Not addicted just kept having issues and this constipated me to only go about once a week. I believe this is what (only tested properly after twenty years of excruciating time) prompted that bacteria overload that was stagnant for so long turned into prime feeding ground into tmau. Now I have been treated for SIBO, and still have the problem so that’s why I think it’s now tmau and here to stay. I smell very skunky in urine a feces.
Im from canada please give some update about this and can my family doctor do that surgery for me here in canada...please let me know thank u..