In Reply.—Thank you for allowing me to comment on Dr. Gilboa's thoughtful letter, in which he cites several references presumably describing cases of Reye syndrome with pancreatitis.
Since it has only been in the past several years that suitable criteria for the diagnosis of Reye synrdome have begun to emerge, there are, regrettably, inherent problems in evaluating reports in the older literature. As has been adequately documented, even in one of Dr. Gilboa's cited references1 (vide supra), what first appears to be Reye syndrome may prove to be something entirely different on closer examination. On the basis of this, we entitled our article, "Idiopathic Acute Pancreatitis in Children: Association With a Clinical Picture Resembling Reye Syndrome" [italics mine].
Several of Dr. Gilboa's references were commented on in our article.2-4 His other references include one case of "encephalitis complicating Rubella" with a duodenal ulcer and pancreatitis,5