Medical News Today: Reye's syndrome: What you need to know


Reye’s syndrome is a rare disorder that can cause serious damage to all organs of the body, but particularly to the brain and liver.

While it can occur in people of any age, it is most common in those aged 18 years or younger and is particularly common in children aged 4 to 12 years old.

Reye’s syndrome is named after Australian pathologist R. Douglas Reye, who first reported cases of the condition back in 1963.

The exact cause of Reye’s syndrome is unknown, but research has suggested a link between the condition and the use of aspirin.

Causes

small boy sick with flu
The cause of Reye’s syndrome is unknown but it commonly affects children who may be recovering from a cold or the flu.

As previously mentioned, the exact cause of Reye’s syndrome is unknown, and there is no known cure. However, it most commonly affects children and young adults who are recovering from a viral infection, such as a cold, flu, or chickenpox.

Cases of Reye’s syndrome are seen more in the winter months than other times of the year. If the disease occurs, an abnormal amount of fat builds up in the liver, while pressure grows on the brain. Without treatment, it can be fatal within just a few days, or even hours.

It is considered a diagnosis of exclusion, meaning that all other possible causes have been excluded before it is decided that a person has Reye’s syndrome.

However, what has been shown since Reye’s syndrome was first discovered is that there are some inherited metabolic disorders that show similar symptoms. The International Aspirin Foundation has estimated that these account for between 10-20 percent of all previous examples of the condition.

Nevertheless, due to aspirin’s connections with Reye’s syndrome, it should never be used to treat viral diseases, such as flu or chickenpox. Children and teenagers should not take aspirin except under special instruction from the doctor.

Symptoms and complications

The symptoms of Reye’s syndrome usually occur in the immediate few days after recovering from a viral infection.

The National Reye’s Syndrome Foundation have broken the symptoms down into four stages, although they stress that often, these symptoms in infants do not follow a pattern.

Stage 1 symptoms:

  • persistent vomiting
  • signs of brain dysfunction
  • listlessness or little interest in things
  • lack of energy
  • drowsiness
  • rapid breathing

Stage 2 symptoms:

  • irritability
  • aggressive behavior
  • other personality changes

Stage 3 symptoms:

  • disorientation
  • confusion
  • anxiety
  • hallucinations
  • irrational behavior

Stage 4 symptoms:

Less than 20 cases of Reye’s syndrome are reported in the United States every year, but because of its severity, it is important to be aware of its symptoms.

Reye’s syndrome also has similar symptoms to many other conditions, so sometimes a second opinion is needed to rule it out.

Other conditions with similar symptoms include:

Emergency care

As Reye’s syndrome can be fatal, anyone who suspects that they or a child has the condition should seek medical help immediately. Early detection is key for successful treatment.

Warning signs to watch out for are constant vomiting, changes in behavior, and extreme tiredness, especially just after having a viral illness.

While those suffering from a virus may show these symptoms anyway, and the chances of it being Reye’s syndrome are very slim, the severity of the condition means it should still be explored.

Risk factors

There are several risks that have been associated with the onset of Reye’s syndrome.

Aspirin

two aspirin tablets
Although the links are inconclusive, there are some suggestions that Reye’s syndrome may be linked with taking aspirin.

Research suggests that there is a link between Reye’s syndrome and taking aspirin while having viral diseases, such as flu or chickenpox.

Though the links are not conclusive, the U.S. Surgeon General, the Food and Drug Administration, the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and the National Reye’s Syndrome Foundation all recommend that aspirin should not be given to anyone under the age of 19 with a fever or signs of viral illness.

Aspirin is used in many different types of medication, including over-the-counter drugs, so always speak to the doctor or pharmacist before taking any.

Chickenpox

Chickenpox is a highly contagious, viral illness that usually lasts for around 5 to 10 days.

The symptoms are a rash that turns into fluid-filled blisters, which then turn into scabs.

Most children who get chickenpox make a full recovery, but it can be very dangerous for anyone with a weakened immune system.

Those people just recovering from chickenpox are at greater risk of Reye’s syndrome and aspirin should not be used as treatment.

Flu

Once again flu, or influenza, should not be treated in children and teenagers with any medication that contains aspirin.

Children under the age of 6 should not be treated with over-the-counter medication at all, and a doctor should be consulted.

Treatment

Intensive care
A Reye’s syndrome diagnosis will be immediately treated in an ICU to protect the brain.

There is no known cure for Reye’s syndrome. However, early diagnosis and successful management can prevent severe complications, such as brain damage or cardiac arrest.

Anyone diagnosed with Reye’s syndrome will be treated immediately in the intensive care unit (ICU).
Treatment aims to support the body’s vital functions, such as breathing and blood circulation, while also protecting the brain against permanent damage caused by swelling.

With no cure, supporting the person’s body is the key to a successful outcome. This can include using the following:

  • Electrolytes and fluids: These keep the person hydrated and maintain the right salt, glucose, and nutrients levels.
  • Diuretics: This is medication to rid the body of excess fluid, such as swelling around the brain.
  • Ammonia detoxicants: These reduce the level of ammonia in the body.
  • Anticonvulsants: These drugs control seizures that might occur.
  • Mechanical ventilation: This may be needed if breathing problems occur.

Outlook

Survival rate for Reye’s syndrome has improved in recent years and is now at about 80 percent.

Early detection and treatment is key to a full recovery, with later diagnosis sometimes leading to permanent brain damage and disability. Those who have lapsed into a coma also have a poorer outlook.

Other long-term problems associated with Reye’s syndrome include:

  • poor attention span and memory
  • some loss of vision and hearing
  • speech problems
  • movement and posture difficulties
  • swallowing problems

Conclusion

Reye’s syndrome is extremely rare, but it can be fatal when it does occur. The condition must be distinguished from other illnesses that can cause similar symptoms. Early diagnosis is essential to avoid long-term health damage, or worse.

For these reasons, it is essential to seek immediate medical attention whenever someone suspects Reye’s syndrome.



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