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Encephalopathy With Hypoglycemia and Degeneration of the Liver

Herbert L. Winograd, MD
JAMA. 1965;194(11):1247-1249. doi:10.1001/jama.1965.03090240081030.
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IN JULY 1965, there appeared two communications reporting, for the first time in the American literature, an entity consisting of encephalopathy, hepatitis, and fat accumulation in the viscera.1,2 The case reported below will add another to this series of reports of this almost unknown entity, for it fits the criteria outlined by both Australian and American authors.

In 1963, Anderson,3 from Melbourne, reported 20 cases of encephalitis with associated liver disease in children aged 3 to 7 years. These cases presented as a febrile illness followed in one or two days by drowsiness, vomiting, and the rapid onset of convulsions or coma. The antecedent illness most frequently initiating this chain of events was an insignificant respiratory disease. In none of the cases was either bacteria or virus recovered. In one of Anderson's cases, the blood-sugar level was noted to be less than 20 mg/100 ml, and the level of


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