Reye's Syndrome
Reye's syndrome is a serious, condition that occurs suddenly, resulting in inflammation of the liver and brain. It most often presents in children aged 4 to 12, but may also occur in adolescents. The syndrome typically appears in children recovering from a virus, such as chickenpox or the flu. Because Reye's syndrome has been statistically correlated with the use of aspirin, extreme caution is advised in administering aspirin to children, especially if they are recovering from viral infections. Fortunately, since warnings concerning the use of aspirin in children have been publicized and heeded, the syndrome has become increasingly rare.
Causes of Reye's Syndrome
The underlying cause of Reye's syndrome is unknown, though it does appear to be triggered by viral infections and has been observed more commonly in children and teenagers who have inherited metabolic disorders. In addition to aspirin, another precipitating factor of Reye's syndrome may be exposure to environmental toxins, such as insecticides or herbicides.
Symptoms of Reye's Syndrome
The symptoms of Reye's syndrome appear quite suddenly, typically about 3 to 5 days after the onset of a viral infection and require immediate treatment. The syndrome may even occur after a common cold. In children under the age of 2, the first symptoms of Reye's syndrome are often rapid breathing and diarrhea. In children older than 2 and in adolescents, the first symptoms are usually persistent vomiting and atypical lethargy. Mental and physical changes become evident as the patient's condition rapidly deteriorates. These may include:
- Confusion, disorientation or hallucinations
- Irritability, aggression, irrational behavior
- Abnormal placement of limbs
- Weakness or paralysis of the limbs
- Seizures
- Diminished consciousness or coma
- Visual or speech disturbances
- Hearing loss
Because Reye's syndrome is a life-threatening condition, a child or teenager whose condition suddenly worsens within a few days of the onset of a viral infection, particularly if the condition involves alterations in behavior or neurological symptoms, should receive emergency medical care. In its absence, the patient may slip into a coma and die.
Diagnosis of Reye's Syndrome
Early diagnosis of Reye's syndrome is crucial to saving the patient's life. Upon physical examination, the doctor may detect, through abdominal palpation, that the liver is enlarged. Blood tests indicating Reye's syndrome may show an abnormally low level of glucose and unusually high levels of acid or ammonia. Other tests administered or performed to diagnose Reye's syndrome include:
- Skin biopsy to test for fatty acid oxidation or metabolic disorders
- CT or MRI scan of the brain
- Liver biopsy
- Lumbar puncture (spinal tap)
The lumbar puncture is necessary to delineate or rule out meningitis and encephalitis as possible causes of the mental symptoms the patient is experiencing. The imaging scans and liver biopsy show whether there are fatty deposits in the liver characteristic of Reye's syndrome.
Treatment of Reye's Syndrome
The only current treatment for Reye's syndrome is supportive therapy. This may include:
- Intravenous hydration
- Electrolyte balancing
- Administration of intravenous glucose
- Monitoring of brain pressure, blood gases, and pH level
- Attachment to a breathing machine
Patients who survive an acute episode of Reye's syndrome usually recover completely. However, if not treated promptly, particularly if the patient has suffered seizures or coma, there may be permanent brain damage.