Unlike flu or fever, the name Reye’s Syndrome may be unfamiliar to Parents’ ears . This syndrome is indeed rare, but this disease is quite susceptible to children and adolescents. Therefore, it doesn’t hurt to be aware of Reye’s Syndrome from the following symptoms, causes and how to prevent it.
What is Reye’s Syndrome?
Reye’s syndrome is a rare but serious illness that causes swelling in the liver and brain. It can affect people of all ages. However, it is most common in children and teenagers who are recovering from a viral infection such as the flu or chickenpox .
Studies have found that the main risk factor for Reye’s syndrome is taking aspirin or related drugs, called salicylates. The syndrome targets the brain, blood, and liver organs.
The symptoms can be life-threatening if not treated promptly. Therefore, doctors recommend that children and adolescents recovering from viral infections should avoid taking aspirin .
Symptoms of Reye’s Syndrome
Symptoms of Reye’s syndrome increase with severity and how the condition affects your child. The first sign of Reye’s Syndrome is a viral infection, such as a cold, upper respiratory infection, flu or chickenpox. After experiencing symptoms of the viral infection for five to seven days, symptoms of Reye’s Syndrome appear, including:
- Diarrhea
- Rapid breathing
- Constant vomiting
- Unusual sleepiness, tiredness, and lethargy
- Recurrent pain
- Showing anxiety, confusion, being easily disoriented or experiencing hallucinations
Increased pressure in the skull (intracranial pressure) causes changes in the child’s brain function, and also affects liver function. As the symptoms of Reye’s Syndrome progress, the condition can become more severe, and may show some of the following signs:
- Personality changes (more irritable or aggressive)
- Confusion or hallucinations
- Weakness or inability to move arms or legs
- Seizures
- Extreme fatigue
- Loss of consciousness
- Coma
- Difficulty clotting blood
- Excess ammonia in their blood
From the above symptoms, this syndrome can be mistaken for other conditions. Including meningitis or swelling of the membranes covering the brain and spinal cord, diabetic reactions, or poisoning.
Causes of Reye’s Syndrome
Doctors don’t fully understand what causes Reye’s Syndrome. It most often occurs after a viral infection and when children are given aspirin (salicylate) to treat symptoms. Viral illnesses that can trigger Reye’s Syndrome include:
- Flu
- Chicken pox
- Respiratory infection
- Common flu
Symptoms of Reye’s Syndrome appear due to increased fluid or pressure in brain tissue (cerebral edema) and changes in their liver.
Studies show that damaged mitochondria can trigger Reye’s Syndrome in the liver. Mitochondria are the part of the cell (organelle) that provides energy (adenosine triphosphate) and are also known as the “powerhouse of the cell.”
Underactive mitochondria affect liver function, causing these symptoms. However, the cause of this mitochondrial damage is unknown.
A person has a greater chance of developing this disease if they:
- Have a disorder that affects how their body breaks down fatty acids
- Have been exposed to certain toxins, including paint thinners and products to kill insects and weeds
When this syndrome strikes, cells throughout the body become swollen and accumulate fat. Eventually, blood sugar levels drop and ammonia and acid levels in the blood increase. These changes can affect many organs, such as the brain and liver, where severe swelling can occur.
Does Aspirin Cause Reye’s Syndrome?
Studies suggest that aspirin (salicylate) may trigger the syndrome and increase the severity of symptoms. As mentioned above, the direct cause of Reye’s Syndrome is unknown.
So, consult your doctor before giving aspirin to your little one during a viral infection like the flu. Always read the labels on all medications before giving them to your child, to check for age requirements and instructions.
How Often Does Reye’s Syndrome Occur?
The incidence of Reye’s Syndrome is decreasing due to increased awareness of the condition. If your child is sick, it is best to avoid giving them aspirin to treat their symptoms. Vaccinations for the flu and chickenpox (varicella) are effective in preventing viral infections, which also contributes to the low number of cases each year.
Diagnosis
Because Reye Syndrome is so rare, other conditions that cause similar symptoms need to be ruled out before diagnosing it, including:
- Meningitis – inflammation of the protective membranes surrounding the brain and spinal cord
- Encephalitis – inflammation of the brain
- Inherited metabolic disorders – conditions, such as medium-chain acyl-CoA dehydrogenase deficiency (MCADD), that affect the chemical reactions that occur in the body.
Blood tests and urine tests can help detect whether there is a buildup of toxins or bacteria in the blood, and can also be used to check whether the liver is functioning normally.
Other tests may also be performed to determine the presence of certain chemicals that may indicate an inherited metabolic disorder.
Tests that may be recommended include:
- CT scan or MRI to check for brain swelling.
- Lumbar puncture – where a sample of fluid is removed from the spine using a needle to check for bacteria or viruses.
- Liver biopsy – where a small sample of liver tissue is taken and examined for specific cellular changes associated with Reye’s Syndrome.
- Spinal taps – where a needle is inserted into the space below the end of the spinal cord to collect fluid.
- Skin biopsy – the doctor scrapes a small sample of skin for testing.
Treatment/Medication
Treatment for the disease focuses on protecting the child’s brain by reducing swelling, reversing liver damage and metabolic injury (lack of oxygen in their blood) and preventing lung complications. Treatments may include:
- Inserting a tube down their throat (endotracheal intubation) to increase their breathing rate (hyperventilation) or using a ventilator.
- Keeping their heads high.
- Take medication to lower the level of ammonia in the blood (ammonia detoxifier).
- Take medication to maintain blood sugar levels (glucose).
- Taking vitamin K or receiving a plasma transfusion to improve blood clotting.
- Intravenous (IV) fluids.
- Diuretics to help the body get rid of salt and water (and stop swelling).
- Medicines to prevent bleeding.
- Administration of vitamin K, plasma, and platelets (small blood cells that help form clots) in cases of liver bleeding.
If your child is diagnosed with Reye’s Syndrome, healthcare providers will immediately admit them to an intensive care unit to monitor their condition. Doctors and nurses will monitor your child’s temperature and all vital organs to make sure treatment is effective.
Are There Any Side Effects from the Treatment?
Most children diagnosed with Reye’s Syndrome make a full recovery. If your child has severe brain swelling, they may face side effects, including:
- Memory loss.
- Learning difficulties.
- Loss of vision and hearing.
- Problems with speech and language.
- Difficulty moving and completing daily tasks such as getting dressed.
Special care may be needed to support your child and meet their needs as they age.
Reye’s Syndrome Prevention
Be careful when giving aspirin to infants, toddlers, and teenagers. Although aspirin is approved for use in children older than 3 years, children and teenagers who are recovering from chickenpox or flu-like symptoms should not take aspirin. This includes regular aspirin and medicines that contain aspirin.
Some hospitals and medical facilities will screen newborns for fatty acid oxidation disorders to see if your baby is at increased risk for Reye’s Syndrome. Children with fatty acid oxidation disorders should not take aspirin or products containing aspirin.
Always check the label before giving any medicine to your child, including over-the-counter products and alternative or herbal remedies. Aspirin can appear in some unexpected medicines, such as Alka-Seltzer.
Sometimes aspirin also has other names, such as:
- Acetylsalicylic acid
- Acetylsalicylate
- Salicylic acid
- Salicylate
For treatment of fever or pain associated with the flu, chickenpox, or other viral illnesses, consider giving your baby or child an over-the-counter fever and pain medication such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin.
There is one caveat to the aspirin rule, however. Children and teens with certain chronic illnesses, such as Kawasaki disease, may require long-term treatment with medications containing aspirin.
If your child requires aspirin therapy, make sure his or her vaccines are up to date, including two doses of the varicella (chickenpox) vaccine and an annual flu vaccine. Avoiding these two viral diseases can help prevent Reye’s Syndrome.
Hopefully this information is useful and can increase Parents’ insight regarding Reye’s Syndrome.
