Detection of 3-hydroxy-3-methyloxindole in human urine.

During routine toxicological screening of urine for possible drug overdose, using two-dimensional thin-layer chromatography, an unknown substance was periodically detected that could not be related to any known drug. The substance was mass-isolated from the urine of a schizophrenic patient, who excreted it prolifically and it was chemically identified as 3-hydroxy-3-methyloxindole by mass spectrometry and 1H- and 13C-NMR. The structure was confirmed by synthesis through methylation of isatin. This is the first report associating 3-hydroxy-3-methyloxindole with human biochemistry. It is thought that this substance is an in vivo oxidation product of 3-methylindole which is a metabolic product of tryptophan, produced by bacteria in the colon.