[Fatty liver, metabolic acidosis and brain edema--Reye's syndrome in adults?]

Three, previously healthy, patients developed profuse vomiting. In the further course of the disease there was a marked deterioration in their general condition with massive metabolic acidosis, cerebral symptoms and, finally, deep coma which ended in death, without any evidence of poisoning. Post-mortem examination revealed diffuse, droplet fatty infiltration of the liver of the degenerative type as well as cerebral oedema without inflammatory signs, findings of Reye's syndrome, rarely seen beyond childhood. The aetiology of this prognostically unfavourable disease remains uncertain, clinical features and laboratory results are very variable. In adults the disease is rarely diagnosed because the syndrome is not known. Only liver biopsy can confirm the diagnosis. Main aim of the symptomatic treatment is to counteract the cerebral oedema.