Reye’s Syndrome

Definition

Reye’s syndrome is a disorder that primarily affects the liver and brain. It attacks the nervous system very quickly and can cause death

Description

Reye’s syndrome primarily affects children and teenagers. In almost all cases, it follows a viral illness, such as a cold (see common cold entry), the flu (see influenza entry), or chickenpox (see chickenpox entry). The disorder can affect any organ in the body, but its most serious effects occur in the brain and the liver. As the disorder develops, it attacks the body’s nervous system. It produces symptoms such as listlessness, confusion, seizures, and coma. In extreme cases, it can lead to death.

Reye’s syndrome is a rare disorder. It was first discovered in the early 1970s. The number of cases of Reye’s syndrome rose slowly until 1980. In that year, 555 cases of the disorder were diagnosed. Researchers had learned at that point that children who are given aspirin are at risk for Reye’s syndrome. Doctors began to warn parents against the use of aspirin with sick children. As a result of those warnings, the number of cases of Reye’s syndrome began to fall. By the late 1990s the condition was very rare in the United States.

Reye’s syndrome is sometimes confused with other nervous-system disorders. The reason for this confusion is that many doctors have never seen a case of Reye’s syndrome. They may diagnose a patient with encephalitis, diabetes, poisoning, or some other condition by mistake. The actual number of cases of Reye’s syndrome may therefore be somewhat higher than the official total.

Causes

The cause of Reye’s syndrome is not known. What researchers do know is that the disorder usually appears after a viral infection in the upper respiratory (breathing) system.

One important fact researchers have discovered is the role of aspirin in Reye’s syndrome. They have learned that people who take aspirin to treat the viral infection are at greater risk for Reye’s syndrome. For that reason, aspirin is no longer recommended for children under the age of nineteen who have a fever.

Symptoms

Whatever the cause, Reye’s syndrome is accompanied by two kinds of effects on the body. First, there is a buildup of fats in body organs, especially the liver. These fats interfere with the normal operation of the organ. They may cause it to shut down.

Second, fluids begin to accumulate in the brain. These fluids push on blood vessels in the brain. The pressure may become so great that blood can no longer flow into the brain. If the brain can no longer function death will result.

The symptoms of Reye’s syndrome appear after a viral infection—after the original viral infection has gotten better. The patient may think that the original disease is over. But new symptoms then appear quite suddenly. The first of these symptoms is violent vomiting. This may be followed by a state of quietness, lethargy, agitation, seizures, and coma. In infants, diarrhea may be more common than vomiting. Fever is usually absent at this point.

Diagnosis

Diagnosis of Reye’s syndrome is often based on the patient’s pattern of illness. The patient may have been ill with a viral disease and then gotten better. If the symptoms described above then suddenly appear, Reye’s syndrome may be suspected.

Confirmation of this diagnosis can be made with a blood test. The test is designed to look for certain liver enzymes. Enzymes are chemicals in the body that change the rate at which reactions take place in cells. When an organ is diseased, the number of enzymes present may increase dramatically. The blood test for Reye’s syndrome involves measuring changes in liver enzymes
Treatment

Reye’s syndrome is a life-threatening emergency. It requires immediate medical attention. The likelihood of recovery is best if the condition is recognized and treated promptly.

The first two steps in treatment are usually an intravenous (into the bloodstream) feeding of sugar and a blood transfusion. These steps help the body recover some of its normal functions. Pressure in the brain is carefully monitored. If it becomes too high, hyperventilation may be needed. Hyperventilation is any process by which the patient is made to breathe more rapidly. The process helps tighten blood vessels in the brain, releasing pressure on the brain.

Prognosis

The death rate for Reye’s syndrome is between 30 percent and 50 percent. The chance of recovery can be as high as 90 percent if the disorder is recognized and treated early. Almost all children who survive Reye’s syndrome recover fully. However, recovery may take a long time. Some patients who recover experience permanent damage to the nervous system. These patients may require special physical and/or educational services and equipment.

Prevention

Since the cause of Reye’s syndrome is not known, there is no certain way to prevent the condition. The best advice seems to be to avoid giving aspirin to children. Aspirin appears to be associated with many cases of Reye’s syndrome. Many products contain aspirin even if that name is not used. Other names that indicate the presence of aspirin in a product include:

* Acetylsalicylate
* Acetylsalicylic acid
* Salicylic acid
* Salicylate

Children who require medication for fever or pain should take other, non-aspirin products, such as acetaminophen (pronounced uh-SEE-tuh-MIN-uh-fin, trade name Tylenol) or ibuprofen pronounced I-byoo-pro-fen).