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  • Reye's Syndrome

    Definition

    Reyes syndrome is a serious but rare condition. It causes a build up of fat and swelling in most organs. Reyes is most harmful to the liver and and brain.
    It tends to occur during recovery from a viral infection. Early treatment is important for a recovery.

    Causes

    The cause of Reyes syndrome is unknown.

    Risk Factors

    Reyes occurs most often in children aged 2-16 years but can occur in anyone. Factors that may increase the risk of Reyes syndrome include:
      Recent viral illness, including:
    • Use of aspirin or other salicylates especially in children during viral illness (like flu or chickenpox)
    • Fatty acid oxidation disorder
    • Exposure to certain toxins

    Symptoms

    Symptoms usually occur after a viral illness and may include:
    • Frequent or persistent vomiting
    • Drowsiness and fatigue
    • Personality changes, such as irritability and aggression
    • Confusion
    • Disordered speech
    • Hallucinations
    • Convulsions
    • Hyperventilation—rapid or deep breathing
    • Loss of consciousness
    Later symptoms may progress to:
    • Coma
    • Seizures
    • Inability to breathe without help
    Call a doctor immediately if you or your child has any of these symptoms, especially after a viral infection.

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Blood tests will be done to evaluate the liver function. To eliminate possibility of other illnesses or disease, your doctor may order tests such as:
    • Spinal tap —to look for infections of the spine or brain
    • Liver biopsy
    • Metabolic tests
    Spinal Tap–Lumbar Puncture Method
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    Treatment

    Early diagnosis and treatment are important for a successful recovery.
    Treatment is focused on protecting the brain and other organs from damage. Options include:

    Medication

    Medications may help to:
    • Decrease inflammation
    • Lower pressure of fluid in the brain
    • Prevent seizures
    • Reduce vomiting
    • Reduce blood ammonia levels (may also require dialysis)
    Glucose and electrolytes may also be given through IV.

    Monitoring

    The brain, heart, and lungs will be carefully monitored. This will help the doctor begin supportive treatments as soon as possible.

    Advanced Care

    As the condition progresses more care may be needed. Some advanced care options include:
    • Ventilator—to take over breathing
    • Drainage procedure or decompression craniotomy—to reduce pressure in the brain

    Prevention

    The exact cause of Reyes is not known but the following may decrease the risk of Reyes syndrome:
    • Do not give aspirin to children and teens with a current or recent viral infection. Check with your doctor before giving aspirin to a child or teen.
    • Avoid giving children and teens medications that contain salicylates. Examples include Alka-Seltzer, Anacin, Bufferin, and Pepto-Bismol.

    RESOURCES

    American Academy of Pediatrics http://www.healthychildren.org/

    National Reye's Syndrome Foundation http://www.reyessyndrome.org

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca

    Alberta Children's Services http://www.child.alberta.ca/

    References

    Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

    Reye Syndrome. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/reye/ . Accessed February 28, 2013.

    Reyes Syndrome. National Institute of Neurological Disorder and Stroke website. Available at: http://www.ninds.nih.gov/disorders/reyes%5Fsyndrome/reyes%5Fsyndrome.htm . Accessed February 28, 2013.

    What is Reyes Syndrome? National Reyes Syndrome website. Available at: http://reyessyndrome.org/what.html . Accessed February 28, 2013.

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