DAS REYE-SYNDROM IM ERWACHSENENALTER

Because of the relatively diffuse diagnostic picture and the large number of diseases with similar symptoms, very strict rules should be applied when diagnosing Reye's syndrome in adults. There is a typical biphasic course with severe vomiting and a non-inflammatory encephalopathy in the second phase. There are clear increases in enzyme activity (GPT, GOT, GLDH), and in the case of GLDH the possibility of a lower molecular inhibitor should be considered plus an increase in the serum ammonia level. There is also a fine droplet fatty degeneration of the liver with centralised nuclei although without a preference for specific sites and without any basic signs of inflammation. Electron microscopy shows signs of mitochondrial injury and histochemical examination shows a lowered mitochondrial enzyme activity. If not all of these criteria are met a further clarification of the disease picture requires that at most there is a suspicion of a Reye's syndrome.