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Reye syndrome
⚠️ Reye syndrome: Avoid Aspirin in children under 12 years due to the strong association with this condition.
🧠 About
- Acute, non-inflammatory encephalopathy.
- Associated with hepatic failure (microvesicular steatosis).
🔗 Associations
- Often follows viral infections → influenza, varicella, gastroenteritis.
- Linked to Aspirin use in ~80% of cases.
- Possible overlap with inborn errors of metabolism (fatty acid oxidation defects).
🩺 Clinical Features
- History of recent viral-like illness.
- Persistent, severe vomiting, malaise.
- Progression: irritability → obtundation → delirium → seizures → coma.
🔬 Investigations
- Liver biopsy: fatty metamorphosis without inflammation.
- ↑ ALT, ↑ AST, ↑ ammonia.
- ↑ Bilirubin, ↑ PT, hypoglycaemia in infants.
- ↑ Urea, ↑ creatinine (renal involvement).
- CT brain: cerebral oedema.
- CSF: mild lymphocytosis.
- Screen for metabolic disorders if atypical presentation.
⚠️ Complications
- Cerebral oedema → herniation (coning), death.
- Status epilepticus.
- SIADH or diabetes insipidus (neuroendocrine complications).
- Acute respiratory failure, aspiration pneumonia.
- Hypovolaemic shock, cardiovascular collapse.
- GI bleeding, pancreatitis, renal failure.
- Sepsis and multiorgan failure.
💊 Management
- Supportive care in HDU/ICU with invasive monitoring.
- Dextrose infusion to prevent/treat hypoglycaemia.
- Correct coagulopathy (vitamin K, plasma, platelets).
- Antiemetics and anticonvulsants if required.
- Prognosis: survival rate ~20–30%; lower ammonia = better prognosis.
💡 Exam Pearl: A child recovering from influenza or chickenpox who suddenly develops vomiting, confusion, and seizures after taking aspirin = think Reye syndrome.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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