An inborn error of metabolism asso ciated with an
offensive body odor, the smell of rotting fish, due to the excessive excretion of
trimethylaminuria (TMA) in urine, sweat, and breath. Persons with TMA may experience
tachycardia (fast heart rate) and severe hypertension (high blood pressure) after
eating cheese (which contains tyramine) and after using nasal sprays containing
epinephrine. TMA is caused by a mutation (change) in the gene for an enzyme, flavin-containing
monooxygenase-3 (FMO3) encoded by a gene on chromosome #1. The FMO3 enzyme metabolizes
tyramine (which is in cheese). The syndrome is associated with various psychosocial
reactions, including social isolation, clinical depression and attempted suicide.
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