Transient intellectual and psychosocial regression during recovery phase of stage V Reye's syndrome.

The outcome of stage V Reye's syndrome survivors has not been critically assessed. Three teenage survivors, who initially exhibited severe psychosocial and intellectual regression, are described. Findings support the observation that the neurological outcome from Reye's syndrome correlates with the duration of altered consciousness during the acute phase.

Inhibition of bone marrow stem cell growth in vitro by methylmalonic acid: a mechanism for pancytopenia in a patient with methylmalonic acidemia.

A 7-week-old infant with methylmalonic acidemia had pancytopenia and hypoplastic bone marrow. The patient responded to large doses of vitamin B12 treatment, and within 3 wk, the blood counts and bone marrow cellularity returned to normal. To understand the mechanism of marrow depression in this infant, we examined the effect of the patient's plasma and methylmalonic acid itself on the in vitro growth of bone marrow-committed stem cells.

Diagnosis and management of acute epiglottitis -- report of 90 consecutive cases.

Ninety children with acute epiglottitis were admitted from 1971 - 1977. Lateral extended neck radiograph was found to be a quick, safe and reliable way to establish the diagnosis. Out of 79, 77 (97%) had blood cultures yielding Hemophilus influenzae type b.

Pharmacokinetics of severe theophylline intoxication managed by peritoneal dialysis.

In a patient severely poisoned with theophylline, saturation kinetics were demonstrated at serum concentrations > 35 micrograms/ml with subsequent conversion to first order kinetics (t 1/2 = 5.4 h). Peritoneal dialysis was used to enhance the drug's removal.

Acute renal failure in Reye's syndrome.

Three patients with initial clinical manifestations and biochemical findings suggestive of a diagnosis of Reye's syndrome had acute renal insufficiency develop and had evidence of consumptive coagulopathy, not generally considered features of the syndrome. As a group, they could not be distinguished, either on the basis of their clinical manifestations or liver pathologic findings, from the 17 patients with Reye's syndrome without renal failure seen in our institution during the same period of time. The use of osmotic diuretics in an effort to decrease cerebral edema may be life threatening in these patients with compromised renal function since hypervolemia, cardiac failure, and worsening of cerebral edema may occur.