What is Reye syndrome?

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 brain
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 chickenpox 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

Badash, Michelle. "Reye's Syndrome." Health Library, November 26, 2012.

Bhutta, Adnan T. “Reye’s Syndrome: Down but Not Out.” Southern Medical Journal 96, no. 1 (January 1, 2003): 43–46.

Parker, James N. and Phillip M. Parker.Reye’s Syndrome: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. ICON Group, 2007.

Kliegman, Robert and Waldo E. Nelson, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders/Elsevier, 2011.

Taubman, Bruce. Your Child’s Symptoms: A Parent’s Guide to Understanding Pediatric Medicine. New York: Simon & Schuster, 1992.

Woolf, Alan D., et al., eds. The Children’s Hospital Guide to Your Child’s Health and Development. Cambridge, Mass.: Perseus, 2002.