PEDIATRICS Vol. 69 No. 1 January 1982, pp. 64-69
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Lactic Acidemia in Reye's Syndrome

James H. Tonsgard MD1, Peter R. Huttenlocher MD1, and Ronald A. Thisted PhD1

1 Departments of Pediatrics and Neurology, University of Chicago Pritzker School of Medicine, and Department of Statistics, University of Chicago, Chicago

Plasma lactate level was measured in 21 patients with Reye's syndrome and was compared with neurologic state as rated on a simple coma scale. Significant elevations in plasma lactate, ranging from 2 to 15 mEq/liter, were noted in all patients. There was a close correspondence between stage of coma at the time the sample was drawn and lactate levels. The correlation of plasma lactate level with clinical stage could not be accounted for by differences in glucose, Po2, Pco2, pH, blood pressure, or serum osmolality. In contrast, blood ammonia level correlated with the severity of the encephlopathy early in the course only and often returned to normal in patients with persistent coma. Other measurements of hepatic dysfunction such as SGOT and SGPT levels failed to correlate with clinical state. All patients had a metabolic acidosis; in five patients it was uncompensated. Lactate accounted for nearly all (mean 81%) of the observed base deficit. The findings suggest that lactic acidemia is an important metabolic component of Reye's syndrome.

Submitted on November 26, 1980
Accepted on February 24, 1981