Reye's Syndrome
Definition
Reye's syndrome is a poorly understood disease afflicting approximately one out of every million children annually. Reye's syndrome is a combination of encephalopathy (brain swelling) and severe systemic illness that strikes children, adolescents and young adults three to seven days after the start of a viral illness.
Description
Influenza (the "flu") and chicken pox are the most common precursors of Reye's Syndrome, but other viruses can sometimes trigger it. Usually the syndrome develops quite suddenly. The child vomits repeatedly and may exhibit unusual behavior, such as lethargy, irrationality, irritability or aggression. In some cases, a normally agreeable child becomes combative or may even hallucinate. The illness can progress rapidly to convulsions, coma, brain damage and death. The syndrome causes an acute change in the cells of the brain and liver. These changes lead to swelling of the brain, imbalance of blood chemicals and malfunction of the liver. The liver loses its ability to filter the blood, eliminate poisons from the body, and maintain glycogen. The latter causes patients to have extremely low blood sugar, and may be one of the reasons they lapse into a coma. When any of these symptoms are present, it is important that the child be seen immediately by a physician to receive the appropriate care.
Causes
The specific cause of the disease is not yet known. It is thought that it may be triggered by any number of factors, including medications, environmental toxins, or a genetic predisposition. Studies have shown that Reye's Syndrome is associated with the use of aspirin. Researchers have found a higher incidence of Reye's syndrome among children using aspirin to relieve symptoms of influenza and chicken pox than among those receiving other drugs to reduce their fevers. Refrain from using aspirin to reduce fevers in children and adolescents. Generally, when treatment of a fever and associated symptoms is necessary, an aspirin substitute (acetaminophen) may be used. Remember, Reye's Syndrome occurs most frequently after widespread outbreaks of influenza and chicken pox. Check the ingredients of the medication you administer. Many common over-the-counter and prescription drugs, including some popular cough and cold remedies, contain aspirin. If your child develops any of the symptoms mentioned above, especially after having influenza or chicken pox, contact your physician immediately. Many children can recover fully if the disease is diagnosed and treated in time.
Treatment
Treatment of Reye's syndrome attempts to control the swelling of the brain and correct the chemical imbalance resulting from a malfunctioning liver. Sometimes liver problems can be corrected to help prevent the accumulation of toxins in the body, and medications may be given to reduce the brain swelling so the possibility of brain damage and other complications is decreased. In essence, the main therapy for this disease is supportive care. Severe cases require surgery to relieve the pressure on the brain. For any of these procedures the patient must be monitored closely, and a respirator is often used.
Questions
What are the signs and symptoms that I should watch out for in the child? Why is Reye's syndrome a serious problem? What are the probable causes? How is it related to flu and chicken pox? Why is aspirin a risk? What aspirin substitutes should I use for the child? What precautions should be taken?
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