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December 13, 1965

Encephalopathy and Fatty Degeneration of the Liver and Kidneys

Author Affiliations

From the University of Oklahoma Medical Center, Oklahoma City. Dr. Howard is a research fellow in infectious diseases, Communicable Disease Center, US Public Health Service. Dr. Jabbour is now at the Child Development Center, University of Tennessee College of Medicine. Dr. Jaques is now at the Veterans General Hospital in Taiwan.

JAMA. 1965;194(11):1245-1247. doi:10.1001/jama.1965.03090240079029

IN 1963, Reye et al1 described a new clinicopathologic entity: "encephalopathy and fatty degeneration of the viscera." The illness began with a mild upper-respiratory-tract infection which subsided and was followed by profuse vomiting, fever, convulsions, and marked alteration in consciousness, respirations, muscle tone, and deep-tendon reflexes. Laboratory findings included hypoglycemia, hypoglycorrhachia, mild acidosis and ketosis and elevation of blood urea nitrogen (BUN), serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase values. Seventeen of the 21 patients died. At postmortem examination, diffuse cerebral swelling, without herniation, and marked fatty infiltration of the liver and proximal tubules of the kidneys were uniformly demonstrated.

Although about 50 patients have been described in the English, Australian, and New Zealand literature, only recently have similar reports appeared from the United States.2-5 This is the report of another patient and a review of the features of this unusual illness.