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Misdiagnosis of Reye's-like Illness

BRIAN W. FORSYTH, MB, CHB; EUGENE D. SHAPIRO, MD; RALPH I. HORWITZ, MD; CATHERINE M. VISCOLI, PHD; DENISE ACAMPORA, MPH
Am J Dis Child. 1991;145(9):964-966. doi:10.1001/archpedi.1991.02160090014005.
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Sir.—There are a number of case reports in the literature describing children with inborn errors of metabolism who have previously been misdiagnosed as having Reye's syndrome.1-4 It is not known, however, whether these cases represent rare events or whether the misdiagnosis of Reye's syndrome is common in clinical practice.

We previously reported5 the results of an epidemiologic study in which we demonstrated that the association between Reye's syndrome and prior exposure to aspirin was not accounted for by bias. In that study, potential cases of Reye's syndrome were reported to the investigators from a network of 108 pediatric tertiary care centers throughout the United States and Canada. The purpose of the present report is to describe the potential for misdiagnosis of Reye's syndrome in clinical practice by comparing the final diagnoses made by physicians who cared for the patients with the diagnoses made by a panel of

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