Reye's syndrome
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REYE'S SYNDROME
Reye's (Reye) 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, most commonly the flu or chickenpox.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 for fever or pain. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin.For the treatment of fever or pain, consider giving your child infants' or children's over-the-counter fever and pain medications such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin. Talk to your doctor if you have concerns.
Symptoms
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 the onset of a viral infection, such as the flu (influenza) or chickenpox, or an upper respiratory infection, such as a cold
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, the symptoms and signs of Reye's syndrome may be duplicated by an underlying metabolic condition unmasked by a viral illness. The most frequent of these rare disorders is medium-chain acyl-CoA dehydrogenase (MCAD) deficiency. Exposure to certain toxins — such as insecticides, herbicides and paint thinner — may produce symptoms similar to those of Reye's syndrome, but these toxins don't cause Reye's syndrome.
How Is Reye Syndrome Treated?
Children with Reye syndrome are usually treated in a hospital. Those who are seriously ill will be cared for in the intensive care unit(ICU).
Treatment is supportive, as there is no cure. The clinical care team will:
- Make sure the child stays hydrated and maintains electrolyte balance.
- Check nutrition intake.
- Watch the child's heart rate and breathing.
- Watch the child's intracranial pressure (pressure of the fluid in the brain) and blood pressure.
Tests done can include blood tests to check electrolytes and liver function and an imaging study of the brain(CAT scan or MRI).
A child also might get:
- small amounts of insulin to increase glucose metabolism
- corticosteroids to reduce brain swelling
- diuretics to get rid of excess fluid
If seizures happen, they'll be treated with medicines. Some kids might need breathing help from a breathing machine or respirator if their breathing gets too slow or ineffective.
The outlook for children with Reye syndrome has improved thanks to earlier diagnosis and better treatment. If the late stages of the syndrome happen, they can cause brain damage, disability, or death
How Can Parents Help Prevent Reye Syndrome?
Never use aspirin or other drugs from the salicylate (suh-LISS-uh-late) family to treat chickenpox, the flu, or any other viral diseases. Many over-the-counter (OTC) medicines contain salicylates, including bismuth subsalicylate (for instance, Pepto-Bismol). Be sure to read the labels and talk to your health care provider if you're not sure whether a medicine is safe for your child.
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