Serum insulin and growth hormone levels and hepatic glycogen and gluconeogenesis were evaluated in patients with Reye syndrome in an attempt to elucidate the mechanism of hypoglycemia. Admission serum insulin levels were low in patients with Reye syndrome. Growth hormone levels were appropriately high.
Patients with Reye syndrome did not respond to glucagon, and liver glycogen as evaluated by PAS staining was depleted. Hepatic gluconeogenesis from pyruvate as evaluated in liver biopsies was markedly depressed in Reye syndrome as compared to animal controls. These results indicate that the hypoglycemia of Reye syndrome is secondary to decreased hepatic glucose production.