Reye Syndrome, or why pediatricians don’t like aspirin
What is Reye syndrome?
Reye syndrome is a potentially fatal condition where the brain and liver are unable to function. The body can’t break down certain fatty acids, which leads to a fatty liver, and too much ammonia in the body. The ammonia leads to swelling in the brain, and other problems.
How do I know if my child has Reye syndrome?
The symptoms of early Reye syndrome are vomiting and a change in your child’s level of consciousness-your child becomes harder and harder to wake up. Since there are many different possible conditions that can cause these symptoms, the child’s recent history, lab tests, CTs or MRIs, and family history of similar problems will help the care team at the hospital determine which illness the child has. Children with Reye syndrome are more likely to have had a recent viral illness (often influenza or chicken pox), and to have had aspirin.
What does it have to do with aspirin?
It was noted in several studies that over 80% of children with Reye syndrome had aspirin within a few weeks of developing symptoms. While this didn’t prove that aspirin was a cause, it was suspicious. Subsequent experiments in labs with aspirin showed a possible mechanism for aspirin contributing to these symptoms, which made the connection more likely.
Can it be treated?
There is no specific treatment for Reye syndrome. There are, however, many different treatments that can be used together to treat the brain swelling, low blood sugar, dehydration, and other problems caused by Reye syndrome.
How well does the treatment work?
Effectiveness of treatment depends partly on which stage the patient is in when the treatment is started. Chance of death is as low as 20% in the earliest stage to 90% in stage 5. Many survivors can have a full recovery, but some can have long term neurologic problems.
Why haven’t I heard of Reye syndrome?
The great part of the Reye syndrome story is that once the possible connection between aspirin and Reye syndrome was discovered in the early 1980’s, people were advised to not use aspirin in children under 18 years old. This, along with testing at birth for ‘inborn errors of metabolism’ (genetic conditions that cause Rye-like symptoms) has led to a huge decrease in cases – from 555 a year to 2 a year.
How do I protect my child from Reye syndrome?
First, avoid aspirin and aspirin containing medicines in children under 18 especially when they have a viral illness. These include things like aspirin, excedrin, alka-seltzer, pepto-bismol, and acne cream with salicylic acid, among others. Occasionally a child has a condition that requires the use of aspirin, which is fine in those cases, and those children can be watched carefully after viral illnesses.
Second, make sure your child has the vaccination series for chicken pox (varicella), and is vaccinated yearly for influenza. Many of the children with Reye syndrome had had one of these viruses previously, so decreasing the chance your child will get chicken pox or influenza protects your child even more.
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