Reyes's syndrome in Delhi

Reye's syndrome in Bangalore

One hundred and twenty four cases of Reye's syndrome admitted to Vanivilas Children's Hospital, Bangalore were investigated. Clinical, biochemical and epidemiological details were obtained. The median age was five years, with no difference in sex ratio. This disease was frequent in winter months. Cases clustered in certain congested localities of the city among lower socio economic strata. Aspirin and varicella could not be associated as preceding factors. The clinical and biochemical features of the patients were suggestive of Reye's syndrome. Histopathological evaluation was done in 104 liver biopsy specimens. Virological studies for influenza and arbovirus were negative. Mortality was high (78%).

Virological investigations of acute encephalopathy in India

A total of 740 consecutive children aged between 6 months and 12 years who presented with acute encephalopathic illnesses during a three year period were assessed both clinically and by laboratory investigations. Cerebrospinal fluid was examined for the presence of cells or other abnormal substances, and any organisms were cultured. Blood examination included white cell count and estimations of haemoglobin, urea, glucose, and electrolyte concentrations and serum alanine aminotransferase and aspartate aminotransferase. A firm diagnosis was established in 278 patients (38%). Pyogenic meningitis (n = 134), measles encephalopathy (n = 38), and electrolyte imbalance (n = 23) were important causes in this group, cerebral malaria (n = 4) was uncommon and there were no cases of Reye's syndrome. The diagnoses of the remaining 462 were combined under the heading 'acute unexplained encephalopathy'. Altogether 394 of the 462 patients underwent virological investigations for arboviruses and 92 (23%) had one or more indicators of Japanese encephalitis. No other arboviruses could be isolated. Throat swabs from 187 patients with acute unexplained encephalopathy were studied on monkey kidney tissue cell lines of which 14 were positive (8%). These were identified as adenovirus, parainfluenza, influenza, poliomyelitis, Coxsackie, and echovirus; in two cases the virus was untypable. Japanese encephalitis is an important cause of acute childhood encephalopathy in this region. Clinical features of the illness may be mimicked by several disorders which require specific treatment. Thirty four of the 92 died (37%).