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Reye's Syndrome: Causes, Symptoms, Treatment and Prevention

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

Below we explain the key aspects of this strange neurological disease which 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 the prestigious medical journal in 1963 The Lancet describing a picture characterized by encephalopathy and liver involvement, they laid the foundations 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 the years 1979-1980.

clinical description

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

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It usually starts three to five days after the child has a viral infection. Particularly those that affect the upper respiratory tract, flu, chicken pox or gastroenteritis, and is related to the use of aspirin during the course of the infection.

Because there are no conclusive specific tests, the doctor will reach the diagnosis clinically, that is, through the clinical history of the symptoms and with the support of results that show the affectation of the liver. Due to 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 can develop fatty deposits. It is common for the brain to swell, causing seizures or loss of consciousness.

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

1. Stage I symptoms

  • Persistent or continuous vomiting
  • Dizziness
  • Languor
  • power loss

2. Stage II symptoms

  • Irritability
  • aggressive behavior

3. Stage III symptoms

  • Confusion
  • irrational conduct
  • Fight

4. Stage IV symptoms

  • Delirium
  • seizures
  • Eat

Unfortunately, the course of Reye's Syndrome is not always the same, and some symptoms may not appear or others may appear in their place, making diagnosis difficult. For example, in babies diarrhea and rapid breathing may appear instead of vomiting, so it does not follow a typical pattern.

Although the presence of vomiting in the absence of infection should already ring some alarm bells, loss of consciousness or seizures is a medical emergency that must 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 part that consults the neurologist before the course worsens.

Preparing for the visit

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

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

It is better to write the most important questions to the least important, in case you do not have time to cover them all. Some basic questions that should be asked of the neurologist handling the case are:

  • What other possible causes could 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 the treatment aims to minimize symptoms and maintain vital functions, such as breathing or circulation. It will also be essential to protect the brain against permanent damage that edema can cause.

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

Assisted breathing may need 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 until the cerebral edema subsides and body functions return to normal.

However, it may take the patient weeks until he can be discharged and out of the hospital.

Prevention

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

In any case, it 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 might otherwise be permanent.

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