An autopsy case of Reye's syndrome associated with acute pancreatitis, acute renal failure and disseminated intravascular coagulopathy.

A three-and-a-half-year-old boy was transferred to our hospital under the impression of Reye's syndrome. The laboratory data showed hypoglycemia, hyperammonemia and elevated serum transaminases. A remarkable high serum amylase level of 2,223 IU/L and CAm/CCr of 36% was noted. A blood urea nitrogen level of 143 mg/dl was found on the third day and a creatinine level of 8.7 mg/dl on the fourth day. Disseminated intravascular coagulopathy (DIC) and systemic candidal infection complicated his final course. He died after intensive treatment for eleven days. Hemorrhagic pancreatitis and fatty change of the liver were noted at autopsy. Disseminated candidal invasion was noted within the kidneys, cerebrum, and lungs. Tonsillar herniation, systemic candidiasis and bronchopneumonia were believed to be the causes of his death. It is extremely rare for all three complications, acute pancreatitis, acute renal failure and DIC, to occur in Reye's syndrome at the e time.