Reye's syndrome

What is Reye's Syndrome?

Reye's syndrome designates a severe pathological picture, typically infantile, which essentially consists of a hepatic and cerebral inflammatory process triggered by the intake of acetylsalicylic acid (the active principle of aspirin).

Not surprisingly, more and more often there is a tendency to recommend avoiding the administration of medicines containing salicylates to children under the age of 12, unless otherwise indicated by the doctor.
Reye's syndrome is a potentially fatal disease, responsible for the progressive wasting of some very important organs, leading to hypoglycemia, encephalopathy, liver inflammation, coma and death. Only early diagnosis of the syndrome seems to be able to save the life of the affected child.

Causes

To date, the precise cause responsible for Reye's syndrome has not yet been identified; what is certain is that the aforementioned syndrome is heavily influenced by the administration of medicinal products based on acetylsalicylic acid (and derivatives) to children under the age of 12. However, the same morbid condition has also been diagnosed in some children who have not taken these active ingredients.
Interesting results emerge from the clinical evidence: it seems that Reye's syndrome occurs in children who are given acetylsalicylic acid for the treatment of flu, infections affecting the respiratory tract (eg cold) or for the treatment of chickenpox: the active principle, in contact with the toxins of the virus, seems to enhance its therapeutic activity, creating exaggerated damage.
Furthermore, the syndrome has often been diagnosed in children with fatty acid oxidation disorders (hereditary diseases of the metabolism - fortunately rare - in which the body is unable to dispose of fatty acids due to an enzyme deficiency).
Still, it seems that chronic exposure to herbicides, insecticides and other toxic substances may, in some way, favor Reye's syndrome, despite the fact that the pathological mechanism triggered remains still an object of study.

Medicines with acetylsalicylic acid

Here are some medicines containing acetylsalicylic acid, which should not be taken by children under the age of 12 (unless otherwise instructed by the doctor):

• aspirin
• Vivin
• Ac Acet
• Alkaeffer
• Aspirinetta
• Istantal
• Salicin
• Cardioaspirin
• Ascriptin

Symptoms

For further information: Reye's Syndrome Symptoms

From recent medical statistics, it is observed that Reye's syndrome tends to appear 3-5 days after the administration of acetylsalicylic acid to children under the age of 12, suffering from the flu, cold or chickenpox. Typically, in children less than 2 years of age, Reye's syndrome begins with dysentery and increased heart rate; in older children, the most recurrent symptoms are drowsiness and continuous vomiting. To these initial symptoms, others are added, such as hallucinations, mood alterations, drop in concentration, mental confusion, weakness, irritability and marked drowsiness. Blood tests also show that something is wrong: glycemic levels are heavily reduced (hypoglycemia), unlike the amount of ammonia in the blood, which increases exaggeratedly over 300mg / dl (hyperammonemia). Sometimes, "hepatomegaly (enlarged liver), associated with convulsions, encephalopathy, epilepsy, loss of consciousness" is also observed , up to coma and death.

Reye's syndrome in adults

Although the chances of Reye's syndrome manifesting itself in adults are very rare, some cases have nevertheless been documented: in such situations, the severity of the disease is rather low and the recovery of full health is usually complete and simple. in fact, that normal liver and brain functions regain full functionality within 14 days from the onset of symptoms. Different speech must be carried out in affected children, since the recovery of intellectual and hepatic abilities is rather complex, especially in the case of diagnostic delay.

Diagnosis

Early diagnosis of Reye's syndrome is essential to save the child's life: we are in fact talking about a "full-fledged medical emergency; therefore, the immediate recognition of a similar pathological condition is very important.
Blood and urine tests, as well as direct medical examination, can confirm Reye's syndrome in a fairly short time. Despite the absence of a specific diagnostic test for the syndrome, the patient is sometimes subjected to more in-depth invasive checks. to verify or not the presence of any neurological dysfunctions. Among these latest medical analyzes, we remember the liver biopsy, the skin biopsy (useful for testing the possibility of a disorder of the oxidation of fatty acids), the lumbar puncture to obtain a sample of cerebrospinal fluid (for the " investigation of encephalitis or meningitis), CT and MRI.

Treatments and drugs

For further information: Medicines for the treatment of Reye's Syndrome

In most cases, patients with Reye's syndrome are hospitalized and kept under close medical observation; the most serious patients are referred to the intensive care unit. The goal of treatment for Reye's syndrome is to reduce the general inflammation of the internal organs and prevent damage, especially in the liver and brain.
Most of the time, the child is rehydrated with intravenous fluids based on glucose and electrolytes: remember, in fact, that hypoglycemia is a characteristic symptom of Reye's syndrome.
For the prevention of bleeding, it is possible to proceed with a treatment with vitamin K associated with an "integration of plasma and platelets. Diuretic drugs are also used in therapy in the context of Reye's syndrome to decrease intracranial pressure, favoring the emission. of fluids with urine. Furthermore, to remove the pathogen, it is possible to administer antibiotics (only in the case of proven bacterial co-infection). To favor the elimination of toxic / harmful substances from the body, the administration of laxatives with a lubricating / emollient action is very useful.
When Reye's syndrome involves the bronchial passages, causing serious breathing difficulties, it is conceivable to use the help of an endotracheal tube.

Prevention

In order to reduce the risk of Reye's syndrome in children, it is recommended to take medications containing paracetamol for the treatment of flu and chickenpox diseases. As a precaution, "active information propaganda aimed at discouraging the use of acetylsalicylic acid and derivatives in children under the age of 12-16" was disclosed to minimize the possibility of Reye's syndrome.