Reye's Syndrome

What is Reye's syndrome?

Reye's syndrome is a rare illness that can be life-threatening. It usually follows a viral infection such as influenza, chickenpox, or an upper respiratory infection. Reye's syndrome is seen most often in children under 15 years of age.

The illness causes:

• low blood sugar
• high levels of acid and ammonia in the blood
• swelling of the brain
• buildup of fat and swelling in the liver. This causes the liver to not work well.

What is the cause?

The exact cause of Reye's syndrome is unknown. Viral infections and the use of aspirin are factors in almost all cases. Children with certain inherited, or genetic, problems may also be at a higher risk for Reye's syndrome. For example, children who have a problem handling waste products produced by the body (such as ammonia).

Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto Bismol.

What are the symptoms?

Symptoms for Reye's syndrome usually begin 3 to 5 days after the start of a viral infection and include:

• fever
• nausea and persistent vomiting for 1 to 3 days
• a gradual decrease in awareness and increased confusion as brain swelling increases
• seizures

If your child has these symptoms, contact your healthcare provider immediately. Get emergency help if your child loses consciousness, is having convulsions, or is very confused.

How is it diagnosed?

Your provider will want to test your child's blood and spinal fluid to check for infection. To test the spinal fluid, your child will need to have a test called a lumbar puncture (spinal tap). A lumbar puncture is a procedure in which a hollow needle is inserted in the spinal canal in the lower back to drain a small amount of spinal fluid. This procedure is very safe. A very small piece of your child's liver may also need to be tested. This is called a liver biopsy.

What is the treatment?

Early diagnosis is the key to successful treatment. Children with Reye's syndrome must be treated at a hospital. The treatment is to reduce the pressure on the swollen brain. Pressure is reduced with medicine given through a vein (IV) and by control of the breathing. Children with severe cases need to have a breathing tube placed in their airway and be ventilated. This helps reduce brain swelling. A pressure monitor is usually placed into the brain to check how much medicine is needed to control the high pressure.

Your child will have blood tests to determine how well the liver is working. Glucose (blood sugar) will be carefully checked and IV fluids with glucose will be given. Because the liver also produces proteins that are responsible for blood clotting, your child may need plasma and blood platelet transfusions. If your child has seizures, medicine will be given to control them.

How long does it last?

Reye's syndrome may last for weeks or months, depending on how severe it is. If the disease is serious, your child may have some brain damage. Reye's syndrome is fatal for some children.

How can Reye's syndrome be prevented?

The best way to reduce the risk of Reye's syndrome is to never give aspirin or any products containing salicylate (such as Pepto-Bismol) to any child 18 years or younger unless specifically told to by your healthcare provider. You can give your child acetaminophen or ibuprofen for pain relief or fever.

Children who need long-term aspirin therapy for diseases such as rheumatoid arthritis should receive the shot form of the flu vaccine. The nasal-spray form of the flu vaccine should not be given to children taking long-term aspirin therapy. Also, do not give these children aspirin for 6 weeks after chickenpox vaccination.