Reye’s syndrome: causes, symptoms, treatment and prevention

A neurological disease that can cause cerebral edema and is potentially fatal.

On rare occasions, children who are recovering from a common infectious disease such as the flu evolve into a condition that causes severe changes in their personality and ends up being lethal. These are the victims of the so-called Reye's Syndrome..

Here we explain the key aspects of this strange neurological disease that seems to be closely related to the use of aspirin in children.

Discovering Reye's Syndrome

When Ralph Douglas Reye, Graeme Morgan and Jim Baral published an article in 1963 in the prestigious medical journal The Lancet describing a condition characterized by encephalopathy and liver involvement, they laid the foundation of knowledge about a disease as rare as it is heterogeneous.

Reye's syndrome, named after the Australian pathologist who first identified the disease, became diagnosable in 1973, reaching its peak incidence between 1979-1980.

Clinical description

It is a disease of unknown cause that especially affects children between 5 and 15 years of age, but can manifest up to 21 years of age.It can manifest itself up to 21 years of age and, very rarely, in adulthood.

It usually originates three to five days after the child suffers a viral infection. Particularly those affecting the upper respiratory tract, influenza, chicken pox or gastroenteritis, and is related to the use of aspirin during the course of the infection.

Since there are no conclusive specific tests, the physician will reach the diagnosis clinically, that is, through the clinical history of the symptoms and with the support of results evidencing liver involvement. Because of the lethality of Reye's syndrome, it is vitally important to know the initial symptoms that characterize the disease. Early diagnosis and treatment can save the child's life.

Signs and symptoms

In Reye's Syndrome Blood sugar levels plummet, while ammonia and blood acidity levels skyrocket.. In parallel, the liver may develop fatty deposits. The brain frequently suffers edema, causing seizures or loss of consciousness.

The type of symptoms suffered by the patient indicates how advanced the disease is. Depending on the severity of the symptoms, the course can be divided into four stages:

Stage I symptoms 2.

• Persistent or continuous vomiting
• Dizziness
• Languor
• Loss of energy

Stage II symptoms

• Irritability
• Aggressive behavior

Stage III Symptoms

• Confusion
• Irrational behavior
• Combativeness

4. Stage IV Symptoms

• Delirium
• Seizures
• Coma

Unfortunately, the course of Reye's syndrome is not always the same, and some symptoms may be absent or others may appear instead, making it difficult to diagnose. For example, in infants, diarrhea and rapid breathing may occur instead of vomiting, so it does not follow a typical pattern.

Although the presence of vomiting in the absence of infection should raise some alarm bells, loss of consciousness or convulsions are a medical emergency that should be treated immediately..

How do we act in case of suspicion?

In most cases, Reye's syndrome will be treated urgently by health personnel due to neurological symptoms. However, there is a small proportion who consult a neurologist before the course worsens.

Preparing for the visit

When the family visits the neurologist, due to the short time usually dedicated to each consultation, it will be helpful if you have followed these tips to get the most out of the appointment.

• Write down in advance any symptoms your child is experiencing.
• Make a list of all medications taken.
• Bring another family member or friend.
• Write down any questions you want to ask the doctor.

It is best to write down questions from most important to least important, in case you don't have time to cover them all. Some basic questions you should ask the neurologist handling the case are:

• What other possible causes might there be for these symptoms?
• What tests are necessary for diagnosis?
• What treatments are available and what are the pros and cons of each?
• What results can I expect?
• What is the next step?

Treatment

Once the syndrome is diagnosed, the child will be immediately admitted to an Intensive Care Unit. There, treatment is aimed at minimizing symptoms and maintaining vital functions, such as breathing or circulation. It will also be essential to protect the brain against permanent damage that may be caused by edema.

Drugs will be administered directly into the vein, including: electrolytes and fluids, diuretics, ammonia-reducing drugs and anticonvulsants.

Ventilation assistance may have to be used if the patient with Reye's Syndrome needs help breathing. Vital signs will be monitored, including heart rate, pulse, blood pressure, air circulation and temperature.air circulation and temperature will be monitored until cerebral edema subsides and body functions return to normal.

However, it may take weeks before the patient can be discharged from the hospital.

Prevention

Because of the possible link between aspirin use and Reye's syndrome, aspirin should only be administered on the advice of a physician when the benefits outweigh the risks. Children under 16 years of age should not take products containing acetylsalicylic acid or salicylic salts, such as some mouthwashes or toothpastes, while safer alternatives are available.

In any case, it is important to be it is important to be alert to the symptoms that children suffer from after an infectionIt is important to be alert to the symptoms that children suffer after an infection, in order to reach an early diagnosis and avoid damage that could otherwise be permanent.