Glucose and
steroids have been used in the treatment of children with
Reye's syndrome, while
carnitine and
coenzyme Q10 have been the subject of some recent studies which suggest that these agents may have a role in the treatment of
Reye's syndrome and
Reye-like syndrome due to
margosa oil poisoning. Because of the paucity of causes of
Reye's syndrome seen at any one centre, the clinical variability of the disease, and limited knowledge of definite aetiologic factors, controlled clinical trials are not easy to carry out or to interpret in human cases. These caveats were overcome by evaluation of these four treatment modalities in an established
margosa-oil-induced animal model of
Reye's syndrome. Effectiveness of the treatment modalities was determined from clinical response and histopathologic parameters (grading of light microscopic fatty changes and ultrastructural changes in the hepatocytes). Results show that
carnitine per se produces a small improvement in survival, but statistically, more significant benefit is seen with
glucose administration.
Carnitine plus 10%
dextrose appears to produce better results. Evaluation of
coenzyme Q10 and
carnitine on histopathologic parameters in the liver after a sublethal dose of
margosa oil showed no obvious ameliorating effect on liver pathology.
Steroids (
dexamethasone/
methylprednisolone) had no beneficial effects in reducing mortality, affecting
glycogen storage or
lipid accumulation. Changes in the mitochondria, ribosomes and endoplasmic reticulum were unaltered from the groups treated with
margosa oil alone. While
glucose and
carnitine supplements appear to be beneficial, the other modes of
therapy do not seem to hold much promise in the treatment of
Reye-like syndrome in the
margosa-oil-induced animal model.