Reye syndrome, an extremely rare but serious illness that can
affect the brain and liver, occurs most commonly in kids recovering
from a viral infection.
Named after Australian pathologist R. Douglas Reye, who first
reported it as a distinct syndrome in 1963, Reye syndrome is still
not well understood. Studies have linked the use of aspirin or
aspirin-containing medications during viral disease to development
of Reye syndrome.
Cases have dropped dramatically since the finding of a link
between the illness and aspirin use in children.
About Reye Syndrome
Reye syndrome predominantly affects kids between 4 and 14 years
old, and occurs most frequently when viral diseases are epidemic,
such as during the winter months or following an outbreak of
chickenpox
or
influenza B
.
Duration varies with the severity of the disease, which can
range from mild and self-limiting to, rarely, death within hours.
Although severity varies, Reye syndrome is a potentially life
threatening disorder that should be treated as a medical emergency.
Early detection and treatment are critical - the chances for a
successful recovery increase greatly when Reye syndrome is treated
in its earliest stages.
Signs and Symptoms
The signs and symptoms of Reye syndrome are almost always
preceded by a viral illness, such as an upper respiratory tract
infection (a cold, the flu, etc.), a diarrheal illness, or
chickenpox. Many cases are mild and may even go undetected; others
can be severe, requiring aggressive care.
Reye syndrome can occur from 1 day to 2 weeks after a viral
infection. The viral illnesses that lead to it are contagious, but
the syndrome itself is not.
Symptoms include:
- persistent vomiting
- lethargy or sleepiness
- in infants, diarrhea and rapid breathing
In the later stages, a child may exhibit irrational behavior,
confusion, severe weakness, seizures, and loss of consciousness.
There is usually no fever.
Reye syndrome is now very rare: only a few cases a year are
reported in the United States. It should be considered, however, in
a child with frequent vomiting or a change in mental status -
particularly after a recent viral illness.
Prevention
Aspirin and other drugs from the salicylate family should
never
be used in the treatment of chickenpox, influenza, and other viral
diseases.
In general,
aspirin should not be used for kids or teenagers
except on the advice of a doctor for certain conditions.
Treatment
Children with Reye syndrome are usually treated in a hospital;
if seriously ill, in a hospital intensive care unit (ICU).
Treatment is supportive as there is no cure for the illness. The
clinical care team focuses on making sure a child with Reye
syndrome maintains proper fluid and electrolyte balance,
nutritional, and cardiorespiratory status. Chances of recovery are
greatest when these systems are as balanced as possible.
Mechanical ventilation (a breathing machine or respirator) may
be necessary if breathing becomes too sluggish. Intracranial
pressure (pressure of the fluid within the brain) and blood
pressure may be monitored. Small quantities of insulin may be given
to increase glucose metabolism, corticosteroids to reduce brain
swelling, and diuretics to increase fluid loss.
The prognosis for children with Reye syndrome has improved.
Earlier diagnosis and better treatment have increased the survival
rate to about 80%. The earlier the syndrome is detected, the better
the chances for survival. Children who progress to the late stages
of the syndrome may suffer brain damage and disability.
When to Call the Doctor
If your child has vomiting, behavioral changes, or extreme
sleepiness, especially after a viral illness such as the flu or a
cold,
contact your doctor immediately
. Of course, many kids with viruses will have some of these
symptoms, and most will not have Reye syndrome. Nevertheless, early
detection is the key to successful treatment of Reye syndrome.
Reviewed by:
Elana Pearl Ben-Joseph, MD
Date reviewed: March 2008
Originally reviewed by:
Lori Patterson, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.