Reye's Syndrome

Written by Cindie Slightham | Published on June 14, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Reye's Syndrome

What Is Reye’s Syndrome?

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.The National Reye’s Syndrome Foundation (NRSF) notes that 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 a doctor or emergency healthcare professional immediately if you think your child might have Reye’s syndrome.

What Causes Reye’s Syndrome?

The cause of Reye’s syndromeis unknown. According to Johns Hopkins and an article published in Drug Safety, studies suggest thataspirin somehow triggers Reye’s syndrome. It typically occurs in children who were given aspirinduring a viral infection. (Glasgow) 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.Parentshave widely been cautioned about giving aspirin to children with viral infections, and reportedcases of Reye’s have greatly declined in recent decades. (Glasgow)

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.

Who Is at Risk for Developing Reye’s Syndrome?

Children and adolescents are primarily at highest risk for developing Reye’s syndrome. However, adultscan also develop the condition.

The risk for developing Reye’s syndrome is higher if a child recently had a viral infection and tookaspirin to treat symptoms. A fatty oxidation disorder may increase his or herrisk of developing Reye’s syndrome. However, this connection is not well understood.

Recognizing the Symptoms of Reye’s Syndrome

Reye’s syndrome is not a contagious condition. However, it often occurs during or shortly after the individual has had a contagious illness.

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 thatlasts 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
  • seizures

You should contact your doctor if these symptoms are seen alongside a viral infection and/or 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 suspectyour child may have Reye’s syndrome.

Diagnosing Reye’s Syndrome

Your doctor will ask about your child’s symptoms. He or shemayorder additional tests to confirm diagnosis, including those described below.

Blood and Urine Tests

Your doctor will check that your child’s liver is functioning normally. He or she will also test for fatty acid oxidation disorders or other metabolic disorders. Indications of Reye’s syndrome include anincrease in liver enzymes and ammonia levels and a decrease in blood glucose.

Spinal Tap

Your doctor will insert a needle through the lower end of your child’sspinal cord and collect a sample of cerebrospinal fluid. He or shewill analyze it for other infections or diseases that could be causing your child’s symptoms.

Liver Biopsy

Your doctor will insert a needle into your child’supper 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 doctor look for changes in the brain that may be causing changes in your child’s behavior. ACT scan produces detailed images of the brain. An MRI uses a strong magnetic field to generate brain images.

Skin Biopsy

In this test, your doctor will take a small skin sample to test for fatty acid oxidation or other metabolic conditions. This procedure can be performed in your doctor’s office and only requires local anesthetic.

Treatment for Reye’s Syndrome

There is no cure for Reye’s syndrome. Treatment focuseson supporting your child through the infection 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:

  • providingelectrolytes, hydration, and glucose intravenously
  • providingsteroids and diuretics to reduce brain swelling and excess fluid
  • providinganti-seizure medication as needed
  • maintainingoxygen levels with breathing support (ventilator) if necessary

Long-Term Outlook for Reyes Syndrome

The outlookvaries 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, yourchild may have no lingering symptoms. Rarely, children may develop brain damage as a result of the illness. Reye’s syndrome can be fatal if left untreated.

Preventing Reye’s Syndrome

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. Thisincludesover-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 productsthat contain aspirin is available from the National Reye’s Syndrome Foundation.

Please note that other names for aspirin include:

  • oil of wintergreen
  • acetylsalicylic acid
  • acetylsalicylate
  • salicylic acid
  • salicylate

Some hospitals have also begun to test newborns for fatty acid oxidation disorders. Talk with your doctor 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.

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