Retinol binding protein and prealbumin in Reye's syndrome

Retinol binding protein (RBP) and prealbumin (PA) were analyzed in 29 serum samples from 8 patients with stages II and III Reye's Syndrome (RS), and from 10 healthy fasting children. All RS patients had at least one abnormally low RBP and PA value. A return toward normal was evident within 2-3 days in serial samples. The nadir RBP and PA values in RS (means of 9 and 107 mg/L) were significantly different (p less than 0.001) from those of the controls (RBP mean of 40 and PA of 157 mg/L). A significant correlation was found between RBP and PA serum values in RS (r = 0.7, p less than 0.001); the high admission NH4+ values tended to associate with low RBP levels; however, the correlation was not very high (r = -0.4, p less than 0.01). The presence of an abnormal vitamin A transport system at an early stage of RS raises the possibility of additional abnormalities in vitamin A metabolism in these patients. The findings of reduced serum levels of complement, clotting factors, fibronectin, and now RBP and PA, suggest a marked short-term impairment of hepatic synthesis of proteins and/or their release in RS.