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ABSTRACT Plasma lactate was measured in 22 children with Reye's syndrome (R.S.) and was compared with the neurologic state at time of sampling. A five stage coma scale was used

(lethargy, stupor, light coma, decorticate state, decerebrate state). Mean plasma lactate for the 5 stages was 1.94 (± 0.33), 3.38 (± 0.33), 4.94 (± 0.82), 10.5 (± 0.87), and 12.38 (± 0.71)

respectively (normal range 0.4-1.4 meq/L). Separation between all except the second and third groups was highly significant (p<0.0005) and a linear trend due to the clinical state was

noted (F1,22=137.9 p<0.0001). Plasma pyruvate, measured in 6 cases, was elevated in proportion to lactate, with a normal mean lactate-pyruvate ratio of 16:1. Lactate values could not be

explained by differences in glucose load. All patients demonstrated a metabolic acidosis which was compensated in most cases. Plasma lactate accounted for most of the observed base deficit

in a majority of our patients (mean of 81%, range 10 to 100%). Blood ammonia correlated with severity of the encephalopathy early in the course only (p<0.05). It has been suggested that

lactic acidemia in R.S. is related to tissue hypoxia or hypoperfusion (Shannon et al., Pediatrics 56:999, 1975). This did not appear to be the case in our patients. Lactic acidemia was an

invariable finding even in mild cases, and is best explained on the basis of dysfunction of mitochondria, leading to a defect in pyruvate metabolism. It is an excellent objective parameter

of severity of the illness in R.S. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Pritzker School of Medicine. Univ. of Chicago. Depts. of Pediatrics and Neurology, James H

Tonsgard & Peter R Huttenlocher Authors * James H Tonsgard View author publications You can also search for this author inPubMed Google Scholar * Peter R Huttenlocher View author

publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tonsgard, J., Huttenlocher, P.

1617 LACTIC ACIDOSIS IN REYE'S SYNDROME. _Pediatr Res_ 15 (Suppl 4), 712 (1981). https://doi.org/10.1203/00006450-198104001-01634 Download citation * Issue Date: 01 April 1981 * DOI:

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