Reye syndrome is a hepatoencephalopathy (inflammation of the liver and brain), primarily affecting children, triggered by the use of Aspirin® or salicylates as a treatment for the fever of a viral infection, such as influenza or chickenpox.
It is rare in adults, and more frequent among children and adolescents, and typically manifests approximately one week after the onset of an upper respiratory tract infection, such as the flu or chickenpox. Additionally, it seems that there may be a genetic predisposition.
It is characterized by symptoms such as vomiting, behavioral changes, agitation, and delirium, which can rapidly progress to convulsions and coma, and ultimately may lead to the death.
Although it is typically linked to the use of Aspirin® or salicylates as a treatment for fever in viral infections, Reye syndrome can also be associated with the use of other medications such as metoclopramide (used for treating vomiting), zidovudine (used for treating HIV), and valproic acid (used for treating epilepsy), albeit in rare cases.
There are 4 stages in the Reye syndrome:
In babies, it is possible that vomiting is not present. They can suffer unspecific symptoms like diarrhea or irregular breathing.
If a child with a previous viral infection has been treated with Aspirin® or salicylates, it is important to conduct the following diagnostic tests:
The treatment for Reye syndrome is very intensive, and therefore hospitalization is necessary.
As Reye syndrome is a highly complex and rare condition, it is recommended that it be managed by a hospital with extensive experience in treating the syndrome at a high level of care.
The treatment is focused on:
The recovery percentage is about 60%. The rest has a bad prognosis usually leading to the death.
The long-term consequences will be determined by the severity of the acute condition and the effectiveness of the individualized treatment approach.
The use of acetylsalicylic acid (Aspirin®) and other salicylates should be avoided as a treatment for fever or malaise resulting from viral infections, flu, or chickenpox in children and adolescents (under 18 years of age).
Instead, Paracetamol or Ibuprofen are safer alternatives for such patients.