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NEUROLOGY 1986;36:435
© 1986 American Academy of Neurology

The metabolic course of Reye's syndrome

Distinction between survivors and nonsurvivors

Edgardo L. Arcinue, MD, Robert A. Mitchell, PhD, Ashok P. Sarnaik, MD and Brian McArthur, MS

Departments of Pediatrics and Biochemistry, Wayne State University School of Medicine and the Children's Hospital of Michigan, Detroit, MI.

We compared the levels of hormones and metabolites in the plasma of 37 survivors of Reye's syndrome with the levels in 8 fatal cases, at four time periods within 72 hours of admission. The most prominent differences were found for norepinephrine (NE), which was significantly elevated in fatal cases compared with survivors at all periods. Lactate and dopamine were elevated in the earlier periods. Epinephrine and alpha-amino acid nitrogen were also elevated in fatal cases, but the differences usually were not significant. NE elevation may reflect an increased sympathoadrenal medullary output associated with brain edema, compounded by impaired hepatic clearance of monoamines. Skeletal muscle ischemia from NE-induced vasoconstriction may explain the association between lactic acidemia and the severity of encephalopathy.

Address correspondence and reprint requests to Dr. Mitchell, Department of Biochemistry, Wayne State University School of Medicine, 540 East Canfield Avenue, Detroit, MI 48201.

This work was supported by the Reye's Syndrome Study Center, Children's Hospital of Michigan.

Accepted for publication July 26, 1985.






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