Reyes Syndrome

Reyes Syndrome is a serious disorder that causes increased pressure in the brain and build-up of fat in the liver and other organs. It affects all organs of the body, but is most harmful to the brain and liver. Reyes Syndrome occurs primarily in children, most often during recovery from a viral infection.

Causes

The cause of Reyes Syndrome is unknown. However, studies have found a link with the use of aspirin and other salicylates during a viral illness.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Age: 2-16 years old
  • Recent viral illness, including:
    • Upper respiratory infection
    • Flu
    • Chickenpox
  • Use of aspirin or other salicylates

Symptoms

Symptoms usually occur after a viral illness, and are divided into five stages:
Stage 1:
  • Frequent or persistent vomiting
  • Drowsiness and fatigue
Stage 2:
  • Personality changes, such as irritability and aggression
  • Confusion
  • Disordered speech
  • Hallucinations
Stages 3-5:
  • Coma
  • Seizures
  • Inability to breathe without help (may occur in stage 4)
Brain swelling and other problems in Reyes syndrome progress very quickly. They may result in permanent neurologic damage or death. Call a doctor immediately if you think your child has Reyes Syndrome.

Diagnosis

The doctor will ask about symptoms and medical history, and perform a physical exam. Tests may include:
Liver Function Tests - These include:
  • SGOT (AST)
  • SGPT (ALT)
  • LDH
  • Ammonia
  • Prothrombin time
Spinal Tap (Lumbar Puncture) – insertion of a needle between the lumbar vertebrae in the back to remove spinal fluid for testing Liver Biopsy – removal of a sample of liver tissue for testing

Treatment

Early diagnosis and treatment are essential for a successful recovery.
Treatment may include:
Medication
Medications include:
  • Corticosteroids
  • Diuretics
  • Glucose
  • Insulin
  • Barbiturates
Arterial Catheter
If symptoms affect the brain, an arterial catheter may be inserted to monitor the pressure and fluid in the head. This tube is placed inside an artery, and will monitor:
  • Blood gases
  • Acidity
  • Blood pressure
Ventilator
In advanced stages, a ventilator may be used to assist with breathing.
Surgery
A drainage procedure or decompression craniotomy may be needed to reduce pressure in the brain.

Prevention

To prevent Reyes Syndrome:
  • Aspirin is not recommended for children and teens with a current or recent viral infection. Check with your doctor before giving aspirin to a child or teen.
  • Avoid giving children and teens medications that contain salicylates. Examples include Alka-Seltzer, Anacin, Bufferin, and Pepto-Bismol.