Hepatic zonal degeneration and necrosis in Reye syndrome

Seven pediatric cases with hepatic peripheral zonal degeneration or necrosis in the liver, or both, were studied. From the standpoint of clinicopathological features, these cases fit best into the spectrum of Reye syndrome. Exogenous toxins, such as phosphorus and drugs, could not be implicated as principal causative factors in any of the cases. In the context of Reye syndrome, fatty acids would seem to have been the toxins most likely responsible for the pathogenesis of the peripheral zonal degeneration and necrosis in the liver.