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Reye's syndrome
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Reye's syndrome

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Diseases & Conditions  

Reye's syndrome is a disorder principally affecting the liver and
brain, marked by rapid development of life-threatening neurological symptoms. Reye's Syndrome should be suspected when vomiting begins 3 to 7 days after the onset of flu or chickenpox.

In Reye's syndrome, the level of ammonia and acidity in the blood typically rises while the level of sugar drops. At the same time, the liver may swell and develop fat deposits. Swelling also may occur in the brain and can cause emergency symptoms such as seizures or convulsions. Reye's syndrome can eventually lead to a coma and brain death.

Many people assume the decline is due to the warnings against children taking aspirin, but that may be only part of the reason.


Screening and diagnosis

If your child becomes sick with a possible case of Reye's syndrome, doctors may want to check his or her liver function. They may also want to evaluate other possible causes of liver problems and investigate any neurologic abnormalities. In addition to blood and urine tests, diagnostic procedures may include:

  • Spinal tap (lumbar puncture). This procedure helps to rule out other diseases with similar signs and symptoms, such as inflammation of the lining and fluid that surround your brain and spinal cord (meningitis) or inflammation or infection of the brain (encephalitis). Local anesthesia is used to numb the puncture site. A needle is then inserted through the lower back into the space around the spinal cord to collect a small sample of cerebrospinal fluid (CSF). The CSF can be analyzed for protein, sugar, and red and white blood cells. The sample also can be cultured to identify bacterial and viral infections.

  • Liver biopsy. In this procedure, a needle is inserted through the skin on the upper right side of the abdomen in order to draw a tissue sample from the liver for laboratory analysis. This analysis is then used to rule out other possible diseases that may be affecting the liver. Sometimes, a liver biopsy is done as an "open liver biopsy." In this case an incision is made in the abdomen, exposing the liver so that a piece of it may be taken for laboratory analysis.

Your doctor also may want to evaluate the possibility that your child has one of the rare, inherited metabolic disorders that can mimic the signs and symptoms of Reye's syndrome. The list of these metabolic disorders is long, and most of them have long unfamiliar terms, such as medium-chain acyl-CoA dehydrogenase (MCAD) deficiency. Most, if not all, of these conditions are inherited and may occur with varying degrees of severity in other family members.

The key to diagnosing or excluding these unusual conditions is obtaining blood and urine samples during the acute phase of the illness and having them analyzed in a qualified biochemical genetics laboratory. Many of these metabolic conditions are termed mitochondrial diseases because the problems arise from the part of body cells called the mitochondria.

If a child dies of a Reye's-like illness, it may be important to obtain blood and urine to check for these metabolic conditions. In addition, collecting samples of liver and brain tissue shortly after death could be the key to diagnosing a condition that might affect other family members. It may even be possible to analyze tissue from an autopsy done many years ago to clarify whether a death was due to a metabolic cause.

Reye's syndrome  > 1 > 2 > 3 > 4

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Last Modified : 03/15/08 02:04 AM