Fatty liver in sudden childhood death. Implications for Reye's syndrome?

We studied the livers of 21 children dying a traumatic death or sudden unexpected natural death and found that fatty metamorphosis of the liver appears to be ubiquitous. Therefore, the finding of microvesicular panlobular fatty liver alone does not justify the diagnosis of Reye's syndrome. In fact, because fatty change appears to be so prevalent, previous reports that relied on fatty changes as diagnostic of Reye's syndrome cannot be validated.