Reye’s syndrome

Symptoms of Reye's

The symptoms of Reye's syndrome usually begin a few days after a viral infection such as:

• a cold
• flu
• chickenpox

Initial symptoms can include:

• vomiting repeatedly
• tiredness and lack of interest or enthusiasm
• rapid breathing
• fits (seizures)

As the condition progresses, the symptoms may get more severe and more wide-ranging, and can include:

• irritability, or irrational or aggressive behaviour
• severe anxiety and confusion that's sometimes associated with hallucinations
• coma (loss of consciousness)

When to get medical advice

Reye's syndrome can be fatal. It’s vital to get medical advice if you think your child may have it.

Dial 999 to ask for an ambulance, or go to your nearest emergency department if your child:

• loses consciousness
• has a fit or convulsions (violent, irregular limb movements)

You should contact your GP or out of hours service  if, after having a cold, flu or chickenpox, your child is:

• vomiting repeatedly 
• unusually tired
• displaying personality or behavioural changes (see above) 

Although it's unlikely these symptoms will be caused by Reye's syndrome, they still need to be checked by a doctor.

Tell your GP if your child has taken aspirin as the use of aspirin in children has been linked to Reye's syndrome. Even if your child hasn't taken aspirin, Reye's syndrome shouldn't be ruled out.

Causes of Reye's syndrome

The exact cause of Reye's syndrome is unknown. It most commonly affects children and young adults recovering from a viral infection. In most cases, aspirin has been used to treat their symptoms.

In Reye's syndrome, it's thought that tiny structures within the cells called mitochondria become damaged. Mitochondria provide cells with energy and are important for the healthy functioning of the liver.

If the liver loses its energy supply, it begins to fail, causing a build-up of toxic chemicals in the blood. This can damage the entire body and cause the brain to swell.

Diagnosing Reye's syndrome

As Reye's syndrome is rare, other conditions that can cause similar symptoms need to be ruled out. These include:

• meningitis – inflammation of the protective membranes surrounding the brain and spinal cord
• encephalitis – inflammation of the brain
• inherited metabolic disorders  – conditions, such as medium-chain acyl-CoA dehydrogenase deficiency (MCADD), that affect the chemical reactions that occur in your body

Blood and urine tests can help detect if there's a build-up of toxins or bacteria in the blood, and can also be used to check if the liver is functioning normally.

Tests may also be carried out to check for the presence or absence of certain chemicals that could suggest an inherited metabolic disorder.

Treating Reye's syndrome

If Reye's syndrome is diagnosed, your child will need to be immediately admitted to an intensive care unit.

Treatment aims to minimise the symptoms and support the body's vital functions, such as breathing and blood circulation.

It's also essential to protect the brain against permanent damage that can be caused by the brain swelling.

Medicines may be given directly into a vein and a ventilator (breathing machine) may be used if your child needs help breathing.

Vital body functions will also be monitored, including:

• heart rate and pulse
• air flow to the lungs
• blood pressure
• body temperature

Once the swelling in the brain has reduced, the other functions of the body should return to normal within a few days. It may be several weeks before your child is well enough to leave hospital.

Possible complications

Most children who develop Reye's syndrome will survive, and some will make a full recovery. Reye's syndrome can leave some people with some permanent brain damage caused by the swelling of their brain.

Long-term problems sometimes associated with Reye's syndrome include:

• poor attention span and memory
• some loss of vision or hearing
• speech and language difficulties
• problems with movement and posture
• difficulty swallowing
• problems with everyday tasks, such as dressing or using the toilet

If your child develops any long-term problems, an individual care plan will be drawn up to address their needs. The plan will be reassessed as they get older.

Preventing Reye's syndrome

Because of the possible link between aspirin and Reye's syndrome, aspirin should only be given to children under 16 on the advice of a doctor when it's felt the potential benefits outweigh the risks.

Children under 16 should also not take any products containing:

• acetylsalicylic acid or acetylsalicylate
• salicylic acid, salicylate or salicylate salts

Some mouth ulcer gels and dental gels contain salicylate salts. There are alternative products that are suitable for under 16s – ask your pharmacist for advice.

More useful links

• How to use your health services