Infection, especially viral infection is very common among people of all ages but mostly they infect infants and young children. Very common viral infection includes cold, sore throat, fever with rashes, vomiting, and diarrhea. These infections are not so serious. Other viral infection that causes serious illness includes measles and chicken pox. But these are now less prevalent, thanks to widespread immunization. Many children with viral infection do not require any treatment and get better on their own. Most of the viral infection is accompanied with fever and bodyache, in such cases doctor prescribe acetaminophen and ibuprofen. Aspirin is usually not prescribed as reports show that they end up in developing a condition called as Reye’s syndrome. More about Reye’s syndrome is dealt in the following sessions of the article.
About Reye’s Syndrome
Reye’s syndrome (RS) is considered a deadly disease, that suddenly and swiftly attacks infants, young children, teenagers, and even adults without any warning. RS usually occurs in conjugation with a previous episode of viral infection that is treated with aspirin. It is generally encountered during the recovery period from a viral infection. It is extremely rare condition, but a very serious condition that is capable of affecting all the organs of the body, especially brain and liver. RS increases the pressure in the brain and results in excess accumulation of fat in the liver and other organs. The severity of the disease varies from mild self limiting to deadly. Though Reye’s syndrome is placed under mild and severe category, it is potentially a life threatening condition that should always be considered as medical emergency.
Causes
RS is commonly seen in children between the ages 4 to 14 years. The exact cause of Reye’s syndrome is unknown but researches have shown that RS usually occurs after a week of viral infection such as influenza and chicken pox. It also seems to develop after a simple upper respiratory tract infection. The exact reason is unknown but it is shown that aspirin and other salicylates usage for treating viral infection trigger RS, especially in children who have fatty acid oxidation disorder. Fatty acid oxidation disorder is a condition in which the body is unable to break down fatty acid due to absence or improper functioning of enzyme. In some children RS may be present already but is brought out by a viral infection. Exposing children to insecticide, herbicides, and paint thinner can also trigger RS.
Symptoms
Symptoms of RS appear after an episode of viral infection and they are categorized under 5 stages.
Stage I includes
- Frequent persistent vomiting
- Fatigue or drowsiness
- Nightmares
- Liver dysfunction
Stage II includes
- Confusion
- Disordered speech
- Irritation and aggressiveness
- Hallucinations
- Severe lethargy
- Hyperventilation
- Hyperactive reflexes
Stage III includes
- Coma
- Cerebral edema
- Respiratory arrest
- Symptoms of stage I and II
Stage IV includes
- Deep coma
- Large pupil but reduced response to light
- Liver dysfunction
Stage V includes
- Coma
- Respiratory failure
- Seizures
- Flaccidity
- Increased blood ammonia
- Death
Complications
Many kids with RS manage to survive but they have to face certain degree of permanent brain damage. Other complications of RS are coma and seizures, which if not attended, can be life threatening.
Diagnosis
RS is usually suspected in kids who exhibit the upper listed symptoms or vomiting within a week of viral infection, which is followed by unpredictable consciousness. To confirm RS the doctor may perform blood test to check the level of certain liver enzymes that is usually high in kids with RS. Other changes in blood include increased level of ammonia, amino acid, decreased blood sugar level, and increased clotting time. A liver biopsy may also be performed to check the fat deposition and causes of abnormal liver enzymes. Liver function tests include many tests that determine how well the liver is functioning. A Computer tomography and magnetic resonance imaging of the head is done to check the condition of the brain and to rule out other causes of abnormal behavior. Spinal tap or lumbar puncture test, which involves puncturing the lumbar region of the spine and drawing the spinal fluid may be done. This is done to rule out the presence of other conditions like meningitis and encephalitis. To look for fatty acid oxidation disorder and metabolic disorder, a skin biopsy may be required.
Treatment
There is no cure for RS, but early and effective treatment procedures help successful recovery. Treatment for RS begins with admitting the kid in intensive care unit. The medical team focuses on maintaining perfect fluid, electrolyte balance; nutrition, and cardio-respiratory status. These are the three basic foundations that help easy recovery. In case of breathing difficulty a mechanical respiratory apparatus will be necessary. Small amount of insulin is given to kids to improve their glucose metabolism. Both intracranial (brain) and blood pressure should be monitored frequently. Corticosteroids are prescribed to reduce brain swelling and diuretics help to increase fluid loss. Anti-seizure medication may be given to prevent seizures. To improve blood clotting vitamin K is prescribed. Occasionally, surgery may be required to reduce the pressure in brain.
Prevention
RS can be prevented by not recommending aspirin for treating a viral infection in children. Consult doctor before giving aspirin to kids. And remember not to give any medicines containing salicylate to kids and teenagers.
Outlook
Reye’s syndrome is a very rare disease but the rarity does not reduce its severity and seriousness. Doctors and parents while giving any medicines to kids and teenagers should follow extra cautiousness. Aspirin administration to kids and teenagers should completely be avoided unless doctor recommends for some conditions. Avoid taking any over-the-counter medications.
