Reye's Syndrome

What is Reye's Syndrome ?

Reye's syndrome is an acute childhood illness that causes fatty infiltration of the liver with concurrent hyperammonemia, encephalopathy, and increased intracranial pressure (lCP). In addition, fatty infiltration of the kidneys, brain, and myocardium may occur. Reye's syndrome affects children from infancy to adolescence and occurs equally in boys and girls. It affects whites over age 1 more often than blacks.

Reye's syndrome almost always follows within 1 to 3 days of an acute viral infection, such as an upper respiratory tract infection, type B influenza, or varicella (chickenpox).

Causes of Reye's Syndrome

The cause of Reye's syndrome is unknown, but viral and toxic agents, especially salicylates, have been implicated. However, scientists have discovered that aspirin or medications containing salicylate can increase the probability of its incidence. One study found that 90% of patients with this disease took aspirin before or during the viral illness. For this reason, parents are advised to consult a physician before treating their children with these medications.

Signs & Symptoms of Reye's Syndrome

Signs & symptoms of Reye's syndrome appear during recovery from a viral infection, such as the flu or chicken pox, that has been treated with ASA products. Symptoms usually develop 3 to 7 days after a viral illness starts. The symptoms develop rapidly over several hours to a day or two.

The first symptoms may include:

• May get vomiting, due to stomach flu.
• Lack of energy, and loss of interest in surroundings.
• Irritability, personality change, and slurred speech.

The onset of Reye's can be rapid, and signs and symptoms may worsen within hours.

As Reye's syndrome progresses, children may develop even more serious signs, including:

• Weakness or paralysis in extremities
• Loss of consciousness
• Seizures or convulsions

Diagnostic Tests

Laboratory tests disclose elevated serum ammonia levels; normal or (in 15% of cases) low serum glucose levels; and increased serum fatty acid and lactate levels. Liver function studies indicate aspartate aminotransferase and alanine aminotransferase at twice the normal levels. Bilirubin levels are normal.

Coagulation studies demonstrate increased prothrombin time and partial thromboplastin time.

Liver biopsy reveals fatty droplets uniformly distributed throughout liver cells.

Treatment

In Reye's syndrome, treatment depends on the disease's stage and must be started as soon as Reye's syndrome is diagnosed because the disease progresses rapidly. Initially, therapy consists of I.V. administration of glucose to prevent onset of coma. Other treatments include airway maintenance, adequate oxygenation, and control of cerebral edema.

Prevention Tips

Because Reye's syndrome is so highly correlated with use of aspirin for fever in young people, avoidance of aspirin use by children is strongly recommended. Aspirin is in many over-the-counter and prescription drugs, including drugs for headache, fever, menstrual cramps, muscle pain, nausea, upset stomach, and arthritis. It may be used in drugs taken orally or by suppository.