PEDIATRICS Vol. 70 No. 6 December 1982, pp. 997-1000
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The Prognostic Significance of Peak Ammonia Levels in Reye Syndrome

JOSEPH F. FITZGERALD MD, FAAP1, JOSEPH H. CLARK MD1, ANASTASIOS G. ANGELIDES MD2, and ROBERT WYLLIE MD3

1 Department of Pediatrics, Indiana University School of Medicine, Indianapolis
2 Long Island Jewish-Hillside Medical Center, New Hyde Park, New York
3 Cleveland Clinic Foundation, Cleveland

Reye syndrome is currently viewed as a specific disease entity distinguished from other causes of hepatic failure and encephalopathy on clinical and histologic grounds. A variety of therapeutic approaches, ranging from supportive management to invasive intracranial pressure monitoring and barbiturate-induced coma, have been used because of the wide spectrum of disease progression and severity. Early identification of factors predictive of a poor outcome would be of value in assessing the need for aggressive management. Based on a ten-year experience with 95 patients with Reye syndrome, we suggest that peak plasma ammonia levels are predictive of disease severity and patient survival.