1/6. brain ultrastructure in Reye's syndrome.Cerebral biopsies were obtained for electron microscopy 48 and 72 hours after the onset of encephalopathy from a child with severe Reye's syndrome. Gravely ill at the time of craniectomy to relieve cerebral hypertension, the child survived and recovered good brain function; therefore, the biopsy findings appear to reflect the organelle pathology of the brain at a severe yet reversible stage in the disease process. The cardinal ultrastructural changes in the brain in Reye's syndrome are astrocyte swelling and partial deglycogenation, myelin bleb formation and universal injury of neuron mitochondria. The mitochondrial injury consists of matrix disruption with moderate but not massive swelling. dilatation of rough endoplasmic reticulum and nuclear changes occurred only in neurons with severely altered mitochondria. The organelle pathology of the brain in this case did not resemble the organelle pathology of the brain in human "hepatic encephalopathy" or in experimental ammonia intoxication in primates. The mitochondrial ultrastructure of the cerebral neurons resembled the unique mitochondrial ultrastructural changes seen in the liver parenchyma in Reye's syndrome.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/6. Acute encephalopathy in siblings. reye syndrome vs salicylate intoxication.siblings, aged 9 and 7 years, had simultaneous onset of vomiting, disorientation, ataxia, and coma. Both children had prodromal symptoms of upper respiratory tract infections, and had been treated with large doses of aspirin. Laboratory data showed evidence of hepatocellular dysfunction, with an elevated serum ammonia level in one patient; salicylate levels were 50 and 44 mg/100 ml. The child who died had autopsy evidence of cerebral edema and fatty liver. The difficulty in clinically differentiating reye syndrome from salicylate intoxication is discussed.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
3/6. Methyl bromide intoxication: neurologic features, including simulation of reye syndrome.Three family members intoxicated with methyl bromide presented with a variety of neuropsychiatric manifestations including coma, severe status epilepticus, hyporeflexia, and acute psychosis. The simulation of reye syndrome in the child emphasizes the need for careful toxicologic screening of all children presenting with this syndrome. The initial diagnostic difficulty encountered in these cases emphasizes the need for heightened awareness of the toxic chemicals used in local industries and the clinical manifestations of their intoxication.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
4/6. Simulated Reye's syndrome and salicylate therapy.A 4-year-old girl with juvenile rheumatoid arthritis developed fever, protracted vomiting, disturbance of consciousness and decorticate posture following the administration of salicylate. There were elevated levels of transaminases in serum, hyperammonemia and a fatty liver. However, the fatty droplets were different electronmicroscopically from that of Reye's syndrome. This observation emphasizes the importance of electronmicroscopic observation of the liver in the differential diagnosis between Reye's syndrome and aspirin-induced encephalopathy, because the clinico-pathological findings of intoxication are so similar.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
5/6. Subacute salicylate intoxication in an infant with echovirus type 11 infection.An antigenic variant of E 11 was the most frequently encountered echovirus in the united states in 1979. Several reports have indicated that infection with this agent was often associated with an overwhelming clinical course in neonates. Our case was in a 5-week-old infant with an E 11 infection complicated by subacute salicylate intoxication. This unfavorable combination resulted in a fulminant and fatal illness simulating Reye's syndrome.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
6/6. A comparison of liver ultrastructure in salicylate intoxication and Reye's syndrome.All childhood liver biopsy specimens from The Cincinnati Children's Hospital research Foundation which had been prepared for light and electron microscopy were reviewed to identify biopsies from children with salicylate intoxication. Only two cases of primary salicylate intoxication were identified. The histopathology and ultrastructural pathology were compared to that in two cases of Reye's syndrome which were selected because they had been treated with salicylates and had comparable serum salicylate concentrations at the time of liver biopsy. Liver biopsy specimens from the cases of salicylate intoxication were nearly normal by light microscopy. Lipid accumulation was minimal, and the content of glycogen and succinic acid dehydrogenase activity was normal. mitochondria and peroxisomes appeared normal. light and electron microscopy of liver specimens from the two cases of Reye's syndrome revealed swollen hepatocytes with microvesicular fat and central nuclei. glycogen content and succinic acid dehydrogenase activity were diminished. All hepatocyte mitochondria were enlarged, pleomorphic, and had an expanded matrix and no mitochondrial dense bodies. The histopathology and ultrastructural pathology of liver biopsy specimens in salicylate intoxication were different from those in Reye's syndrome. In children in whom the diagnosis of Reye's syndrome is obscure, liver biopsy with electron microscopic examination is necessary for definitive diagnosis.- - - - - - - - - - ranking = 8keywords = intoxication (Clic here for more details about this article) |