Reye's Syndrome

What is Reye’s syndrome?

Reye’s syndrome is a rare childhood disease that can be fatal. It usually strikes children under the age of 15 who are recovering from an upper respiratory illness, chicken pox or influenza.

Reye's Syndrome is a very serious disease that you should know about.  Some people develop Reye's Syndrome as they are getting over a viral illness, such as the flu or chicken pox.  Reye's Syndrome usually affects people from infancy through young adulthood; however, no age group is immune.  Although Reye's generally occurs when someone is recovering from any viral illness, it can develop 3 to 5 days after the onset of the illness.  Its main targets are the liver and brain, it is noncontagious, and too often is misdiagnosed as encephalitis, meningitis, diabetes, poisoning, drug overdose,  or sudden infant death.

Reye Syndrome is a rare condition that may follow an upper respiratory infection or a case of varicella (chickenpox). People with Reye Syndrome have nausea, vomiting and a change in mental status. To be diagnosed as Reye Syndrome, an illness must meet the following criteria:

• Acute, noninflammatory encephalopathy (disease of the brain) that is documented clinically by a) an alteration in consciousness and, if available, b) a record of the cerebrospinal fluid containing less than or equal to 8 white blood cells/cubic millimeter or a histologic specimen of the brain demonstrating cerebral edema (swelling) without perivascular or meningeal inflammation
• Hepatopathy (disease of the liver) documented by either a) a liver biopsy or an autopsy considered to be diagnostic of Reye Syndrome or b) a threefold or greater increase in the levels serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), or serum ammonia
• No more reasonable explanation for the brain and liver abnormalities

What is the cause of Reye’s syndrome?

The cause of Reye’s syndrome is unknown, but studies have found a link with the use of aspirin during a viral illness. For this reason, aspirin should not be given without a doctor’s approval to any child under the age of 16. Reye’s syndrome causes a severe increase in pressure in the brain and abnormal amounts of fat in the liver. It develops as the child recovers from an infection. Usually the first symptom is uncontrollable vomiting and nausea. Other early symptoms include feeling sluggish, sleepy and confused and easily annoyed. The swelling in the brain may cause seizures and coma and the child may stop breathing. A child with Reye’s syndrome needs immediate medical care. The earlier it is diagnosed the better the chance for a successful recovery.

How is Reye Syndrome diagnosed?

There is no specific laboratory test to diagnose Reye Syndrome. A case of Reye Syndrome is confirmed when a case meets the clinical case definition.

Early diagnosis is crucial.  An individual should be watched during the next 2 to 3 weeks following a viral illness for these symptoms, usually occurring in this order:

• Relentless or continuous vomiting
• Listlessness (loss of pep and energy with little interest in their environment)
• Drowsiness (excessive sleepiness)
• Personality change (such as irritability, slurred speech, sensitivity to touch)
• Disorientation or confusion (unable to identify whereabouts, family members or answer questions)
• Combativeness (striking out at those trying to help them)
• Delirium, convulsions or loss of consciousness

Reye's Syndrome should be suspected in anyone who vomits repeatedly.  Phone your doctor immediately if these symptoms develop.  Voice your concern about Reye's Syndrome.  If your physician is unavailable, take the person to an Emergency Room promptly. Two liver function tests (SGOT, SGPT) can be done to determine the possibility of Reye's Syndrome.  There is a 90% chance of recovery when the syndrome is treated in its earliest stages by physicians and nurses experienced in the treatment of Reye's.

Studies have shown that using aspirin or aspirin-containing medications to treat the symptoms of viral illnesses increases the chance of developing Reye's Syndrome.  If you or a member of your family have a viral illness, do not use aspirin or aspirin-containing medications.  In fact, you should consult your physician before you take any drugs, particularly aspirin or anti-nausea medicines, to treat flu, chicken pox or any viral illness.

Anti nausea medicines may mask the symptoms of Reye's Syndrome.

How can Reye Syndrome be prevented?

Children who have an upper respiratory infection or varicella should not be given aspirin or aspirin-containing products without specific physician instructions to administer these medicines.

Is there a treatment for Reye’s syndrome?

Treatment includes drugs to control the swelling in the brain and intravenous fluids to restore normal blood balance. The child may have to be placed on a ventilator to help with breathing.