Reye's Syndrome Health Article

Definition

Reye's syndrome is a disorder principally affecting the liver and brain, marked by rapid development of life-threatening neurological symptoms.

Description

Reye's syndrome is an emergency illness chiefly affecting children and teenagers. It almost always follows a viral illness such as a cold, the flu, or chickenpox. Reye's syndrome may affect all the organs of the body, but it most seriously affects the brain and liver. Brain swelling and massive accumulations of fat in the liver and other organs lead to the rapid development of severe neurological symptoms, including lethargy, confusion, seizures, and coma. Reye's syndrome is a life-threatening emergency, with a fatality rate of about 30 to 50 percent.

Demographics

Reye's syndrome is a rare illness, even rarer in the early 2000s than when it was first described in the early 1970s. The incidence of the disorder peaked in 1980, with 555 cases reported. The number of cases declined rapidly thereafter once researchers made the association between aspirin use and the development of Reye's syndrome. Cases dropped precipitously when parents and healthcare providers were clearly warned against using any aspirin-containing products in children. As of 2004, fewer than 20 cases of Reye's syndrome are reported annually. Because of the rarity of Reye's syndrome, it is often misdiagnosed as encephalitis, meningitis, diabetes, or poisoning, and the true incidence may be higher than the number of reported cases indicates.

Causes and symptoms

Reye's syndrome causes fatty accumulation in the organs of the body, especially the liver. In the brain, it causes fluid accumulation (edema), which leads to a rise in pressure in the brain (intracranial pressure). This pressure compresses blood vessels, preventing blood from entering the brain. Untreated, this pressure increase leads to brain damage and death.

Although as of 2004 the cause remains unknown, Reye's syndrome appears to be linked to an abnormality in the energy-converting structures (mitochondria) within the body's cells.

Reye's syndrome usually occurs after a viral illness with fever, most often an upper respiratory tract infection. It is most often associated with use of aspirin during the fever, and for this reason aspirin and aspirin-containing products are not recommended for people under the age of 19 during fever. Although rare, Reye's syndrome may occur without aspirin use and in adults.

After the beginning of recovery from the viral illness, the affected person suddenly becomes more ill again, with the development of persistent vomiting. This may be followed rapidly by quietness, lethargy, agitation or combativeness, seizures, and coma. In infants, diarrhea may be more common than vomiting. Fever is usually absent at this point.