Reye syndrome
Reye syndrome is a rare, noncontagious condition primarily affecting the liver and central nervous system in individuals under eighteen. While the exact cause remains unclear, it is often associated with recovery from mild viral illnesses, such as chickenpox or influenza, and may be linked to the use of aspirin during these infections. Initial symptoms include sudden vomiting, high fever, headache, and drowsiness, which can progress to confusion, convulsions, and loss of consciousness. The disease can lead to severe complications, including swelling of the liver, kidneys, and brain, with potential outcomes ranging from permanent brain damage to death.
While there is no known cure, early recognition and supportive treatment, such as fluids and medications to manage swelling, are crucial for improving outcomes. Historically, the fatality rate was high, but advancements in diagnosis and care have significantly lowered this rate. Given the potential risks, it is generally advised that aspirin be avoided for children with viral infections, with acetaminophen or ibuprofen recommended as safer alternatives. Understanding Reye syndrome is vital for prompt medical intervention, particularly during the critical early stages of the illness.
Reye syndrome
ANATOMY OR SYSTEM AFFECTED: Brain, circulatory system, heart, kidneys, liver, nervous system, urinary system
DEFINITION: A somewhat rare, noncontagious disease of the liver and central nervous system that strikes individuals under the age of eighteen
CAUSES: Unclear; likely related to mild viral infection and possibly aspirin use
SYMPTOMS: Sudden onset of vomiting, high fever, headache, drowsiness, alternating excitation and confused sleepiness, convulsions, loss of consciousness
DURATION: Acute
TREATMENTS: Fluids, glucose, and other nutrients; medications (mannitol); surgery to reduce pressure in skull
Causes and Symptoms
The exact cause of Reye syndrome has not been determined, but the majority of patients develop the disease while recovering from a mild viral illness, such as chickenpox, influenza, or a minor respiratory illness. It is theorized that the virus combines with another unknown substance or substances in the body to produce a damaging poison. Reye syndrome usually occurs in children between four and twelve years of age. For reasons not well understood, the taking of salicylates, such as aspirin, during viral illnesses may precipitate the development of this potentially fatal illness.
The first symptom of the disease is a sudden onset of vomiting, then high fever, headache, and drowsiness. Blood sugar levels drop, while blood ammonia and acidity levels increase. As the disease progresses, alternating states of excitation and confused sleepiness may occur, as well as convulsions and a loss of consciousness. In the final stages of the disease, damage occurs to the liver, kidneys, and brain. The liver swells and develops large amounts of fat deposits. The cells swell and pressure builds in the skull, followed by coma, permanent brain damage, and, in some cases, death.
Reye syndrome is often mistaken for a number of other disorders, including meningitis, encephalitis, diabetic shock, or poisoning, potentially complicating the early diagnosis that is crucial for treating this condition.
Treatment and Therapy
There is no known cure for Reye syndrome. Early recognition and specialized care may be lifesaving. If a child begins to exhibit symptoms of Reye syndrome shortly after a viral illness, then competent medical care must be sought immediately. Treatment consists of helping the victim survive the first few days of the illness through intake of fluids, glucose, and other nutrients. If the patient survives the first three or four days, the symptoms usually subside and recovery follows. The degree of recovery, however, depends upon the degree of brain swelling of the patient during the illness. Some children suffer permanent brain damage.
Medication, such as mannitol, or surgery will reduce the pressure within the skull if it reaches dangerous levels. Although it has not been proven that aspirin causes or promotes Reye’s syndrome, based on a variety of medical studies, it is recommended that aspirin not be given to children with viral infections, especially and influenza. With few exceptions, acetaminophen or ibuprofen are safe alternatives.
Perspective and Prospects
Reye syndrome was first described by an Australian pathologist, R. D. K. Reye, in 1963. In the early 1980s, approximately 50 percent of the cases were fatal, but improved diagnosis and treatment of the disease had reduced that number to less than 10 percent by 2006.
Bibliography
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