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We report the case of a 9-year-old boy referred to secondary care with an unusual presentation of a fishy odour to his hands, feet, saliva and urine. Laboratory investigations including urine analysis and genetic testing confirmed the diagnosis of trimethylaminuria. The patient was referred to a geneticist and dietician, and consequently treated with dietary modification. He now has an arguably much improved quality of life.
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Mitchell SC. Trimethylaminuria (fish-odour syndrome) and oral malodour. Oral Dis 2005;11 1):10–3. 10.1111/j.1601-0825.2005.01081.x
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Mackay RJ, McEntyre CJ, Henderson C et al. . Trimethylaminuria: causes and diagnosis of a socially distressing condition. Clin Biochem Rev 2011;32:33–43.
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