Reye's Syndrome Associated With Adenovirus Infections

Sir.—Reiteration of the observation that Reye's syndrome (RS) occurs occasionally in association with virus other than influenza and varicella is valuable; however, Edwards et al¹ have misrepresented some of the implications of our study of the clinical and histologic manifestations of mild RS.² We do not, as stated in the second column of their discussion, "question" the well-established observations of mitochondrial alterations in RS and would not wish to be included in a list of authors who do. Indeed, without the specific mitochondrial alterations, as described by Partin et al,³ there is little to distinguish those children with RS from the myriad of children dying with fatty liver and cerebral edema of diverse and nonspecific cause. Our study in reality strengthens the case in support of the specificity of this lesion.

The source of the misconception of Edwards et al must lie in the stringent criteria