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Lactic acidemia in Reye's syndrome

J H Tonsgard, P R Huttenlocher, R A Thisted

    Pediatrics
    |January 1, 1982
    PubMed
    Summary

    Elevated plasma lactate levels are significantly linked to the severity of coma in Reye's syndrome patients. This finding highlights lactic acidemia as a key metabolic issue in this condition.

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    Area of Science:

    • Neurology
    • Metabolic Disorders
    • Pediatrics

    Background:

    • Reye's syndrome is a severe condition affecting the brain and liver, primarily in children.
    • The metabolic derangements in Reye's syndrome are not fully understood.
    • Previous studies have explored various biochemical markers in Reye's syndrome.

    Purpose of the Study:

    • To investigate the relationship between plasma lactate levels and the neurological status in patients with Reye's syndrome.
    • To determine if plasma lactate levels correlate with the clinical stage of Reye's syndrome.
    • To compare the correlation of lactate with other biochemical markers like ammonia and hepatic function tests.

    Main Methods:

    • Plasma lactate levels were measured in 21 patients diagnosed with Reye's syndrome.
    • Neurological status was assessed using a simple coma scale.
    • Correlations were analyzed between plasma lactate, coma stage, and other parameters including glucose, blood gases, osmolality, ammonia, SGOT, and SGPT.

    Main Results:

    • All patients exhibited significantly elevated plasma lactate levels (2-15 mEq/liter).
    • A strong correlation was observed between plasma lactate levels and the stage of coma.
    • Lactate levels correlated with clinical stage independently of glucose, blood gases, or osmolality.
    • Blood ammonia correlated with encephalopathy severity early on but normalized in persistent coma.
    • Hepatic function tests (SGOT, SGPT) did not correlate with clinical state.
    • Metabolic acidosis was present in all patients, with lactate accounting for 81% of the base deficit.

    Conclusions:

    • Lactic acidemia is a significant metabolic component of Reye's syndrome.
    • Plasma lactate levels serve as a reliable indicator of neurological severity in Reye's syndrome.
    • Monitoring lactate may be crucial for assessing disease progression and patient outcomes.

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