Reye's (Ryes) syndrome is a rare but serious condition that causes swelling in the liver and brain. Reye's syndrome most often affects children and teenagers recovering from a viral infection and who may also have a metabolic disorder. Signs and symptoms such as confusion, seizures and loss of consciousness require emergency treatment. Early diagnosis and treatment of Reye's syndrome can save a child's life.
Aspirin has been linked with Reye's syndrome, so use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.
In Reye's syndrome, a child's blood sugar level typically drops while the levels of ammonia and acidity in his or her blood rise. At the same time, the liver may swell and develop fatty deposits. Swelling may also occur in the brain, which can cause seizures, convulsions or loss of consciousness.
The signs and symptoms of Reye's syndrome typically appear about three to five days after a viral infection, such as the flu (influenza) or chickenpox, or an upper respiratory infection, such as a cold.
Initial signs and symptoms
For older children and teenagers, early signs and symptoms may include:
Additional signs and symptoms
These signs and symptoms require emergency treatment.
When to see a doctor
Seek emergency medical help if your child:
Contact your child's doctor if your child experiences the following after a bout with the flu or chicenpox:
The exact cause of Reye's syndrome is unknown, although several factors may play a role in its development. Reye's syndrome seems to be triggered by using aspirin to treat a viral illness or infection — particularly flu (influenza) and chickenpox — in children and teenagers who have an underlying fatty acid oxidation disorder. Fatty acid oxidation disorders are a group of inherited metabolic disorders in which the body is unable to break down fatty acids because an enzyme is missing or not working properly. A screening test is needed to determine if your child has a fatty acid oxidation disorder.
In some cases, Reye's syndrome may be an underlying metabolic condition that's unmasked by a viral illness. Exposure to certain toxins — such as insecticides, herbicides and paint thinner — also may contribute to Reye's syndrome.
The following factors — usually when they occur together — may increase your child's risk of developing Reye's syndrome:
Most children and teenagers who have Reye's syndrome survive, although varying degrees of permanent brain damage are possible. Without proper diagnosis and treatment, Reye's syndrome can be fatal within a few days.
Preparing for your appointment
Reye's syndrome is often diagnosed in an emergency situation because of serious signs and symptoms, such as seizures or loss of consciousness. In some cases, early signs and symptoms prompt a doctor's appointment. You'll likely be referred to a doctor who specializes in conditions of the brain and nervous system (neurologist).
Because appointments can be brief and there's often a lot of ground to cover, it can help to be well prepared. Here are some tips to help you get ready for your appointment.
What you can do
List your questions from most important to least important in case your time with your doctor runs out. For Reye's syndrome some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Tests and diagnosis
There's no specific test for Reye's syndrome. Instead, screening for Reye's syndrome usually begins with blood and urine tests as well as testing for fatty acid oxidation disorders and other metabolic disorders.
Sometimes more invasive diagnostic tests are needed to evaluate other possible causes of liver problems and investigate any neurological abnormalities. For example:
Lumbar puncture (spinal tap)
During a lumbar puncture (spinal tap) procedure, you typically lie on your side with your knees drawn up to your chest. Then a needle is inserted into your spinal canal — in your lower back &...
Treatments and drugs
Reye's syndrome is usually treated in the hospital. Severe cases may be treated in the intensive care unit. The hospital staff will closely monitor your child's blood pressure and other vital signs. Specific treatment may include:
If your child has trouble breathing, he or she may need assistance from a breathing machine (ventilator).
Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This includes plain aspirin and medications that contain aspirin.
Some hospitals and medical facilities conduct newborn screenings for fatty acid oxidation disorders to determine which children are at greater risk of developing Reye's syndrome. Children with known fatty acid oxidation disorders should not take aspirin or aspirin-containing products.
Always check the label before you give your child medication, including over-the-counter products and alternative or herbal remedies. Aspirin can show up in some unexpected places, such as Alka-Seltzer. Sometimes aspirin goes by other names, too, such as:
If your child has the flu, chickenpox or another viral illness, use other medications — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve) — to reduce high fever or relieve pain.
There's one caveat to the aspirin rule, however. Children and teenagers who have certain chronic diseases, such as Kawasaki disease, may need long-term treatment with drugs that contain aspirin. If your child needs aspirin therapy, make sure his or her vaccines are current — including two doses of the varicella (chickenpox) vaccine and a yearly flu vaccine. Avoiding these two viral illnesses can help prevent Reye's syndrome.
Last Updated: 2011-09-17
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