Aflatoxin and Reye's syndrome: a study of livers from deceased cases

In order to reinvestigate a strong reported association, we attempted to identify aflatoxin in the livers of 12 children who presumably died of Reye's Syndrome and in the liver of one child who died accidentally. Aflatoxins were detected, but not confirmed in only one of the liver specimens (limits of detection 20 ppt). In addition, the microscopic appearance of the livers was reviewed. Although most of the cases fit the clinical definition of Reye's Syndrome, the microscopic appearance of the liver was varied. We conclude that aflatoxin is not regularly recoverable from cases of Reye's Syndrome at a high rate, and question the proposed etiologic relationship. We confirm the varied appearance of the liver late in the course of Reye's Syndrome; however, microvesicular fat was present in most cases.