Recurrent Reye's Syndrome-Reply

In Reply.—We appreciate the comments of Drs Newman and Schubert. Both have emphasized in their correspondence the primary stimulus for our report, ie, the need to develop a systematic diagnostic approach to patients with Reye's syndrome, especially those with recurrence, to rule out the toxic and metabolic disorders that are known to simulate the syndrome. This is important for us to recognize as clinicians since certain of these biochemical masqueraders may be amenable to more specific therapy and may require counseling with respect to genetic or toxicologic implications for other members of the family or the community. In addition, a complete and systematic evaluation of diagnostic alternatives is also required of us as scientists or else the search for the elusive etiology of this syndrome will only become confused and prolonged.

This work was supported in part by grant RR-69 from the General Clinical Research Centers Program of the