Potential hazard of therapy for Reye's syndrome with urea cycle intermediates

To the Editor: In the December 1975 issue (Pediatrics 56:1081, 1975), Thaler presents a working hypothesis of the pathogenesis of Reye's syndrome. Included in the report is a section on therapeutic implications, where it is suggested that ornithine, arginine, or citrulline might be a specific treatment for this disorder. However, this treatment potentially could make the hyperammonemia worse.1 Therefore, I would like to point out several difficulties with the hypothesis and review the potential hazard