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Previous studies have demonstrated alterations in plasma free fatty acid content in Reye's syndrome (RS). We have therefore studied erythrocyte membrane lipids to determine if there are concomitant structural and functional modifications attributable to RS. Erythrocyte lipids were measured in children with RS and in critically ill children also requiring intensive care (ICU). In comatose RS patients erythrocyte phospholipid arachidonate was increased 2-fold relative to control ICU patients: 20.46 +/- 2.14 versus 10.41 +/- 2.32% of total erythrocyte phospholipid, p less than 0.05. RS coma patients also demonstrated an increased ratio of erythrocyte phospholipid polyunsaturated/saturated fatty acids (0.76 +/- 0.10) compared to ICU controls (0.48 +/- 0.08, p less than 0.05). Erythrocyte cholesterol was higher in RS patients (79.00 +/- 6.61 micrograms/mg protein) than in ICU controls (59.74 +/- 6.09, p less than 0.05). Erythrocyte malondialdehyde generation was decreased in comatose RS patients (404 +/- 28 nmol malondialdehyde/g hemoglobin) versus ICU (517 +/- 29, p less than 0.05). Although plasma vitamin E was depressed in RS patients, the erythrocyte vitamin E concentrations were no different in RS patients than in ICU patients. All RS patients had a typical viral prodrome and either a history of aspirin intake and/or measurable serum salicylate on admission. All of the biochemical abnormalities in RS patients listed above returned to values comparable to those of healthy RS siblings on recovery. The transient nature of these phenomena suggests that they were related to viral infection and/or aspirin rather than to intrinsic differences in lipid metabolism between RS patients and controls.

Erythrocyte Lipid Abnormalities in Reye's Syndrome