To the Editor: Jamaican vomiting sickness and Reye's syndrome are characterized by profound brain edema and coma. Tanaka et al. have confirmed the presence of hypoglycin in patients with Jamaican vomiting sickness (N Engl J Med 295:461, 1976), and Trauner and Nyhan have suggested that the resulting increase in serum fatty acids resembles that seen in Reye's syndrome (N Engl J Med 295:1481, 1976). However, neither the hypoglycemia nor the moderate increase in serum fatty acid levels that occur in both conditions appears to provide an adequate explanation for the devastating neurologic symptoms, as indicated by Dr. Tanaka (N.
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