With reference to the viewpoint(1), we wish to share our experience of
Acute Encephalopathy Syndrome in Bangalore(2) and Reye’s Syndrome in
Bangalore(3).
An ICMR study was conducted during the period of
October 1986 to December 1986 on 269 cases of Acute Encephalopathy
admitted to Vani Vilas Children Hospital. Out of these 124 were
diagnosed as having Reye’s Syndrome (RS). This report was the largest
series from a single centre/City in India.
One hundred and twenty four cases of Reye’s
syndrome admitted to Vani Vilas Children Hopital, bangalore were
investigated. Clinical, biochemical and epidemiological details were
obtained. The median age was five years, with no difference in sex
ratio. This disease was frequent in winter months. Cases clustered in
certain congested localities of the city among lower socio econnomic
strata. Aspirin and varicella could not be associated as preceding
factors. The clinical and biochemical features of the patients were
suggestive of Reye’s Syndrome. Histopatho-logical evaluation was done
in 104 liver biopsy specimens and 102 brain specimens (post mortem).
Virological studies for influenza and arbovirus were negative.
Mortality was high (78%). During this period CT scan was not available
and hence brain CT was not done in any of these cases.
We share this experience of the largest published
series, so that the astute pediatrician keeps these conditions in mind
under mysterious outbreaks of Killer Brain Diseases. Off late for
reasons not known, incidence of RS has decreased, though sporadic
cases are reported. It is surprising to note that the expert team did
not carry out the investigations for RS. It is very unfortunate that
so many children died without a proper workup.
I entirely agree with Dr. Jacob John’s view.
Periodic sensitization of Pediatricians is necessary to be aware of
the rare, but not uncommon disease of RS especially during epidemics.
We personally feel IAP should constitute an expert group to
investigate such out breaks.
D.G. Benakappa,
Asha Benakappa,
601, First Cross, 30th Main,
Banashankari III Stage,
Bangalore 560 085, India.
