Reye syndrome

What is Reye syndrome?

Reye syndrome is a condition that affects the normal chemical balance in the body, resulting in damage to the brain, kidneys, and liver.

As the inflammation in the brain increases, the pressure inside of the head may also increase. The increased pressure in the head causes neurological changes in the child.

It has a very rapid onset that can cause the child to go into a coma, or can result in death within hours of the symptoms.

What causes Reye syndrome?

The exact cause of Reye syndrome is unknown. The more common cases of Reye syndrome are associated with a viral infection from the following sources:

• Respiratory infection - 60 to 75 percent of cases.
• Chickenpox - 15 to 30 percent of cases.
• Diarrhea - 10 to 15 percent of cases.

Reye syndrome usually affects children between the ages of 4 and 12, and is most common at age 6.

Studies show that there is an association between the ingestion of products containing aspirin in children who have a viral illness and Reye syndrome. As a result, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) have released warnings to the public about the relationship between aspirin and Reye syndrome. Parents should not give aspirin to children unless instructed by your child's physician.

What are the symptoms of Reye syndrome?

The following are the most common symptoms of Reye syndrome. However, each child may experience symptoms differently. A child may have had a viral illness such as a respiratory infection, chickenpox, or diarrhea before experiencing symptoms of Reye syndrome. Symptoms may include:

• A full or bulging fontanelle (a soft spot on the top of the head in infants).
• Sleepiness or lethargy.
• Sudden and prolonged vomiting.
• Combative behavior.
• Rapid breathing and heart rate.
• Seizures.
• Coma.
• Increased intracranial pressure.
• Increased irritability.
• High-pitched cry.

The symptoms of Reye syndrome may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

How is Reye syndrome diagnosed?

The diagnosis of Reye syndrome is made after the sudden onset of specific symptoms and after diagnostic testing. During a physical examination, your child's physician obtains a complete medical history of your child. Your child's physician may also ask if the child has recently had a cold or other viral illness, and whether the child has taken aspirin or medication containing aspirin.

Diagnostic tests that may be performed to confirm the diagnosis of Reye syndrome include the following:

• Blood and liver function tests
• Urine and stool tests
• Liver biopsy - a small amount of tissue is removed from the liver and studied to help diagnose different illnesses.
• Electroencephalogram (EEG) - a procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.
• Lumbar puncture (spinal tap) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.
• Intracranial pressure monitoring (ICP) - measures the pressure inside of the child's skull.

Treatment of Reye syndrome

Specific treatment for Reye syndrome will be determined by your child's physician based on:

• Your child's age, overall health, and medical history.
• The extent of the condition.
• Your child's tolerance for specific medications, procedures, or therapies.
• Expectations for the course of the condition.
• Your opinion or preference.

Although there is no cure for Reye syndrome, there are some treatment options. The key to medically managing Reye syndrome is early detection.

A child with Reye syndrome requires immediate hospitalization in the intensive care unit and close monitoring by the healthcare team. This is a serious illness that can quickly worsen.

The goal of treatment is to monitor and reduce the pressure in the head and to provide supportive care (treatment of symptoms) to the child. Medications are used to control the inflammation in the brain, seizures, fever, or other conditions that may be present.

The extent of the problem is dependent on the severity of the condition and the presence of other organ system problems that could affect the child. In severe cases, a breathing machine may be required to help the child breathe easier.

Prevention of Reye syndrome

Parents should read medication labels carefully and avoid giving children products containing aspirin during times of illness. Consult your child's physician for questions regarding medications and dosage.