Baliga R, Fleischmann L E, Chang C H, Sarnaik A P, Bidani A K, Arcinue E L
Am J Dis Child. 1979 Oct;133(10):1009-13. doi: 10.1001/archpedi.1979.02130100033006.
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.
三名患者最初的临床表现和生化检查结果提示为瑞氏综合征诊断，随后出现急性肾功能不全，并伴有消耗性凝血病的证据，而这通常不被认为是该综合征的特征。作为一组病例，无论是基于临床表现还是肝脏病理检查结果，他们都无法与同期在我们机构就诊的17例无肾衰竭的瑞氏综合征患者区分开来。对于这些肾功能受损的患者，使用渗透性利尿剂试图减轻脑水肿可能会危及生命，因为可能会出现血容量过多、心力衰竭和脑水肿加重的情况。
