Sir.—I read with interest the article in the Journal (133:1009-1013, 1979) by Baliga and co-workers, who described three patients with Reye's syndrome associated with disseminated intravascular coagulation (DIC) and acute renal failure. The authors emphasized the importance of initial and continuing evaluation of renal function in Reye's syndrome, especially in patients receiving osmotic diuretic therapy.
I would like to stress another point. All patients received fresh frozen plasma because of a severe coagulopathy compatible with DIC. The coagulopathy did not improve after administration of the coagulation factors and, subsequently, exchange transfusions were done. Thrombocyte counts were near normal on admission to the hospital but decreased during the course of the disease.
Administration of plasma and plasma products, in particular prothrombin complex concentrates, can induce or accentuate DIC with liver disease.1-5 In 1977, Grubbauer and I described an infant with severe Reye's syndrome in whom DIC and renal failure