Reye Syndrome is an extremely rare, non-contagious disease thought to be triggered by aspirin use.  The actual origin of the disease is unknown.  Reye’s Syndrome, occasionally called Reye-Jacobsen’s Syndrome, is known to follow any viral infection.  Two of the most common viral infections it precedes is influenza, “the flu”, and chicken pox.  A now-familiar warning on bottles of aspirin, most notably Tylenol, is not to give Tylenol to a child who is recovering from the chicken pox, a fever, or any other viral infection.  The link between aspirin and Reye’s Syndrome and is not fully understood, but all reported cases of Reye’s Syndrome include a child who has received aspirin before infection.

Symptoms

Symptoms of Reye’s Syndrome may often be mistook for a recurrence of the flu, or extreme exhaustion.  These symptoms include vomiting, confusion, lack of coordination, distorted balance, irritability, a stupor-like state, and a recent infection from a viral illness.  The symptoms often begin with vomiting and progress to a stupor and near comatose state. This disease is often found in young children and infants.  Over sixty percent of reported Reye’s Syndrome cases occur in children under the age of sixteen, with the majority of these cases being in children under six.  Although less than five percent of Reye’s Syndrome cases occur in people over the age of sixty, the elderly are often the most severely affected, due to old age and weakening immune systems.  Infants, while hindered by their young age, can often fight the infections of Reye Syndrome better, for reasons doctors do not yet fully understand. The severity of Reye’s Syndrome is classified on a scale of 1-5, with one and two being the onset of symptoms and four and five being the most severe, with the patient being comatose. With the most severe of Reye’s Syndrome cases, internal fluid builds up in the brain and there is irreversible brain damage or even death.  While the disease is not often fatal, it is essential to treat the disease early.  Reye’s Syndrome is not contagious, but the diseases that can lead to, such as the flu, and chicken pox, are highly communicable.

The first case of Reye’s Syndrome was diagnosed in 1963.  Looking back into medical journals, there were many “mystery illnesses” that had the same symptoms as Reye’s Syndrome, but no cases were positively diagnosed as being Reye Syndrome until this date.  The definitive tests for this disease are a liver biopsy and blood analysis.  The liver biopsy can help determine the presence of fat and lipid formation in the liver.  Upon surgical examination, the liver is slightly enlarged, firm, and bright yellow.  This includes some of the symptoms of jaundice, but without the yellowing of the skin and pupils of the eye. There is often bile build-up within the liver, and fat formation on the liver walls is always present.  The blood test can detect the presence of ammonia and acid within the blood.  The failing liver will produce these chemicals.  There is also a dramatic decrease in blood sugar levels, which can mistakenly be diagnosed as hypoglycemia. Therefore, a liver biopsy is essential in making a complete and correct diagnosis of Reye’s Syndrome.

Treatment

The treatment for Reye’s Syndrome had made great advancements in the last decade.  Through the 1960’s and the 1970’s, the fatality rate for victims of Reye’s Syndrome was over forty percent.  In the 1990’s, this fatality rate has decreased to less than ten percent.  Part of this decrease is due to a greater elevation of public awareness.  Doctors are able to give more complete information to their patients.  Parents who have children recovering from the flu and chicken pox are warned never to give aspirin for fever and pain.  Another reason for the decrease in fatalities is due to increasingly better understanding of the disease.  Before the first diagnosis in 1963, patients who could have had Reye’s Syndrome were treated with medication for intestinal and stomach flu, or given anti-nausea drugs and aspirin(obviously, a big no-no) and sent home with instructions to call the doctor if it got any worse.  Many of these “treatments” ended in death for the patient.  Treatment of the patient now includes cortosteroids to treat brain swelling.  This has greatly helped reduce the occurrence of moderate to severe brain damage in patients with Reye Syndrome.   All treatment is given intravenously, which can help to stabilize the blood chemistry.  Stabilizing this is extremely important to the survival of the patient because of the high levels of ammonia and acid within the body that circulate through the blood.  The treatment given to people with Reye’s Syndrome is more passive than active treatment.  This includes monitoring the heart rate, giving intravenous fluid to prevent dehydration, and keeping fevers down.

Depending upon the severity of the illness, the recovery periods will vary from case to case.  The younger a child, the longer the recovery period, which can last anywhere from two weeks to three months.  When a patient has contracted Reye’s syndrome after having the chicken pox or influenza, as opposed to a common cold or other viral infection, the recovery period is substantially lengthened.

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