Reye’s syndrome is a rare but serious condition that strikes without warning. It most often affects children ages 4 to 12 who are recovering from a viral infection. Reye’s syndrome results in sudden swelling and inflammation of the liver and the brain. These symptoms can progress rapidly and cause death.
Reye’s syndrome should be treated as a medical emergency. Early detection and management by a healthcare professional play a key role in successful treatment. Call your child’s healthcare professional immediately if you think your child might have Reye’s syndrome.
Reye’s syndrome is not a contagious condition. However, it often occurs during a contagious illness or shortly afterward.
Symptoms can range from mild to severe. These symptoms can be mistakenly attributed to other conditions. The disease can be fatal if left untreated. Seeking immediate medical treatment decreases the risk of permanent brain damage and disability.
Potential symptoms include:
- vomiting that lasts for several hours
- lethargy or drowsiness
- diarrhea, especially in infants
- rapid breathing
- aggressive behavior or irritability
- confusion or any other unusual changes in mental status
You should contact your healthcare provider if these symptoms are seen alongside a viral infection and use of aspirin or salicylates. Other symptoms that can occur as the disease progresses include:
- hearing loss
- double vision
- paralysis or loss of muscle function
- abnormal speech
It is important to seek medical attention quickly if you suspect your child may have Reye’s syndrome.
The cause of Reye’s syndrome is unknown. It is believed that aspirin triggers Reye’s syndrome. It typically occurs in children who were given aspirin during a viral infection. Common viral illnesses that can trigger Reye’s syndrome are the flu, chickenpox, or an upper respiratory infection. A cause-effect relationship has not been established for Reye’s syndrome and these disorders. Parents have widely been cautioned about giving aspirin to children with viral infections, and reported cases of Reye’s have greatly declined in recent decades.
It is also believed that Reye’s syndrome may be the result of a fatty oxidation disorder. These are disorders in which your body lacks the enzymes needed to break down fatty acids. If given aspirin, children with this type of metabolic disorder may be more likely to develop Reye’s syndrome.
Toxins such as herbicides, pesticides, and paint thinner may also be linked to the development of Reye’s syndrome. The link between Reye’s syndrome and exposure to those toxins has not yet been fully proven.
Children and adolescents are primarily at highest risk for developing Reye’s syndrome. However, adults can also develop the condition.
The risk for developing Reye’s syndrome is higher if a child recently had a viral infection and took aspirin to treat symptoms. A fatty oxidation disorder may increase their risk of developing Reye’s syndrome. However, this connection is not well understood.
Your healthcare provider will ask about your child’s symptoms. They may order additional tests to confirm diagnosis, including those described below.
Blood and Urine Tests
Your healthcare provider will check that your child’s liver is functioning normally. They may also test for fatty acid oxidation disorders or other metabolic disorders, or may refer you to a specialist who may test for these disorders. Indications of Reye’s syndrome include an increase in liver enzymes and ammonia levels and a decrease in blood glucose.
Your healthcare provider may also deem it necessary to collect a sample of cerebrospinal fluid. They will analyze it for other infections or diseases that could be causing your child’s symptoms.
If indicated, your healthcare provider may request a liver biopsy. This procedure is performed by a physician specially trained in the technique. It involves insertion of a needle into your child’s upper right abdomen to take a small sample of liver tissue. This will help determine if there are any other diseases or conditions that may be affecting the liver and causing your child’s symptoms.
Computed Tomography (CT) or Magnetic Resonance Imaging (MRI)
These scans will help your healthcare professional look for changes in the brain that may be causing changes in your child’s behavior. A CT scan produces detailed images of the brain. An MRI uses a strong magnetic field to generate brain images.
In this test, your healthcare provider will take a small skin sample to test for fatty acid oxidation or other metabolic conditions. This procedure can be performed in your provider’s office and only requires local anesthetic.
There is no cure for Reye’s syndrome. Treatment focuses on supporting your child through the acute period. Most likely, your child will have to stay in the hospital during that time. Treatment will consist of alleviating and monitoring the symptoms, including:
- providing electrolytes, hydration, and glucose intravenously
- providing steroids and diuretics to reduce brain swelling and excess fluid
- providing anti-seizure medication as needed
- maintaining oxygen levels with breathing support (ventilator) if necessary
The outlook varies among children and depends on many factors, including the severity and progression of the syndrome.
The survival rate for children with Reye’s syndrome in the United States has risen to 80 percent. The earlier the problem is detected, the better your child’s chances for survival. If diagnosed and treated quickly, your child may have no lingering symptoms. In very rare cases, children may develop brain damage as a result of the illness. Reye’s syndrome can be fatal if left untreated.
Children or teenagers should never be given aspirin or other salicylate-based medications to reduce fever or relieve pain.
It is important to check ingredient labels before giving your child any medication. This includes over-the-counter, alternative, or herbal products. Even products such as sunscreen, deodorant, and soaps can contain salicylates and should be avoided. A complete list of products that contain aspirin is available from the National Reye’s Syndrome Foundation.
Please note that other names for aspirin include:
- oil of wintergreen
- acetylsalicylic acid
- salicylic acid
Some hospitals have also begun to test newborns for fatty acid oxidation disorders. Talk with your obstetrics provider to determine if this preventative measure is right for your child.
Some chronic conditions require the regular use of aspirin to be managed (e.g., Kawasaki disease). You should work with your doctor to manage both your child’s aspirin use and the risk of developing viral infections.