The Reye Syndrome What is it? A real and present danger
Definition: It is a deadly disease that attacks quickly and can attack any child, adolescent or adult without warning. All the organs of the body are affected mainly the liver and the brain, which are the ones that suffer with greater seriousness.
While the cause and cure remain unknown, research has established a link between Reye’s syndrome and the use of aspirin and other medications containing salicylates, over-the-counter products and topical products.
Reye’s syndrome is a two-phase disease because it is almost always associated with a previous viral infection such as the flu (flu), the cold or chickenpox. Scientists know that Reye Syndrome is not contagious and the cause is unknown.
Reye’s syndrome is often misdiagnosed as encephalitis, meningitis, diabetes, drug overdose, intoxication, sudden infant death syndrome, or psychiatric illness.
Reye syndrome tends to appear more frequently during January, February, and March when influenza is more common. Cases are reported in all months of the year. An epidemic of influenza or chicken pox is commonly followed by an increase in the number of cases of Reye’s syndrome.
When Reye Syndrome develops, it usually occurs when a person begins to recover from a viral illness.
Abnormal accumulations of fat begin to develop in the liver and other organs of the body, along with a severe increase in pressure in the brain. Unless diagnosed and treated successfully, death is common, often within a few days and even a few hours. A person’s life depends on early diagnosis.
The statistics indicate an excellent chance of recovery when the Reye Syndrome is diagnosed and treated in its earliest stages. The later the diagnosis and treatment, the more severely reduced are the chances of recovery and successful survival.
Suspicion of Reye in an infant with:
- Diarrhea, but not necessarily vomiting.
- Respiratory disorders such as hyperventilation or apneic episodes, seizures and hypoglycemia are common.
- A high level of SGOT-SGPT (SAT-ACT) [usually 200 or more units] in the absence of jaundice.
Reye Syndrome should be suspected in a person if this pattern of symptoms appears during, or more commonly, after a viral illness. Not all symptoms have to occur, nor do they have to be shown in this order. Fever is not usually present. Many diseases have symptoms in common.
Doctors and medical staff in emergency rooms who have not had experience in the treatment of Reye’s syndrome may misdiagnose the disease.
Suspect the presence of Reye’s syndrome in a patient who also has:
- Unexpected vomiting after any viral illness, such as a respiratory infection above the flu or chicken pox (in which there is usually no diarrhea).
- Signs of altered brain function characterized by:
- Agitated delirium.
- Screams for no reason.
- Behavior similar to the reaction to the drug.
- Extending spasms.
- Descerebration of rigidity.
- Symptoms similar to aspirin poisoning.
- Presence of hypoglycaemia and / or hepatomegaly.
Initial treatment for Reye’s syndrome
- 10% glucose in saline.
- Maintain the airway and oxygen of the brain.
- Consult a teaching hospital or a children’s hospital.
After Reye’s Syndrome
It is possible for the SR survivor to recover completely without side effects or observable changes. However, there may be a recovery with brain damage and disabilities ranging from very small motor or learning disabilities to deep brain injuries.
What are the potential problems of the survivor of Reye’s syndrome?
Reye syndrome can cause brain damage and disability in some survivors. The number of SR cases that fall into this category is not registered.
If damage occurs, it can vary from mild to profound, depending on the individual case. In the same way, rehabilitation requirements range from minimal remediation to institutional care.
Given that there is a wide range of possibilities, and since these possibilities are somewhat unpredictable, parents should be aware of potential problems and the appropriate services that may be necessary. Early assessment after physiological recovery should be carried out for the purpose of identifying problems and beginning any remediation and / or appropriate educational therapy.
The following are specific problem areas that can be observed:
Problems with attention
- Problems with memory
- Difficulty with concentration
- Speech and language difficulties
- Problems with fine or gross motor skills.
- Changes in the level of activity of the child
- Difficulty with completion of the task
Any specific problem can occur individually or in combination with others. Any or all of the above may manifest itself in learning or academic problems.
For example, a change in academic performance may reflect a change in the ability to attend or concentrate on a task. Difficulty with math, spelling, writing or reading may occur.
A pre-existing learning problem may become more severe after Reye’s syndrome. In addition, some SR remnants may appear after recovery to have no residual effects; however, problems can be observed later in the areas mentioned above.
The evaluation for learning disabilities requires a multidisciplinary team composed of the child’s pediatrician or primary care physician, neurologist, psychologist, educators, family and possibly others such as a speech therapist, physiotherapist and occupational therapist.
This evaluation may be requested by the parent through the local school system.
When the child comes home from the hospital
There are many adjustments required by the family that is suddenly faced with the fact of having a child with brain injuries or another child with special needs. These children need a lot of attention, understanding and, therefore, use a lot of the energy of the family.
Parents should realize that the child returning from the hospital may be a very different child from the one who entered the hospital with Reye. Their abilities can be very altered and, in fact, the child’s personality may have changed.
Recovery is related to the severity of brain swelling. Some people recover completely. Others may suffer brain damage, which ranges from mild to severe brain dysfunction.
The following features are common after hospitalization:
- Refusing to eat or overeat.
- Sleep disorders.
- Moistening or soiling of the bed.
- Regression to previous levels of behavior.
- Motor tics
- Depression, anxiety.
- Fear of hospitals and medical staff.
- States that are not very communicative; (withdrawal from contact with other people).
- More concerned about the body (hypochondria).
Once at home after the hospital stay, the child should not become the center of attention. He or she should have the same burden of responsibility as they previously had as soon as possible.
For the benefit of all family members, there should be a return to normal family life to the extent that medical indications allow.