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DESCRIPTION
Reye's Syndrome is a rare, serious disease that affects many internal organs, particularly the brain and the liver. It primarily strikes children between the ages of 4 and 14 years of age (usual range is between 6 and 12 years of age). Most cases of Reye's Syndrome occur in children who were given aspirin or aspirin-containing medications for a viral infection such as the flu or chickenpox. Reye's syndrome has also been associated with Epstein-Barr virus, influenza B, and enteroviruses (viruses that infect mainly the gastrointestinal tract).
Reye's syndrome primarily targets the brain and liver. Brain swelling and chemical changes in the blood from liver damage affect the entire body. Drowsiness, confusion, seizures, coma, and in severe cases, death may result.
Cases of Reye's syndrome peaked in the 1970s and early 1980s. Today, most children and teenagers who are evaluated for Reye's syndrome do not have the disease. Still, prevention remains important. The basic rule: Do not give aspirin to anyone age 18 or younger, unless specifically recommended by the child's health care provider.
FREQUENT SIGNS & SYMPTOMS
Symptoms of Reye's syndrome begin 3 to 7 days after the onset of the viral illness such as the flu or chickenpox, or an upper respiratory infection, such as a cold. The symptoms develop rapidly over several hours to a day or two.
In Reye's syndrome, a child's blood sugar level typically drops while the level of ammonia and acidity in his or her blood rises. At the same time, the liver may swell and develop fatty deposits. Swelling may also occur in the brain, which can cause seizures, convulsions or loss of consciousness.
For children younger than age 2, the first signs of Reye's syndrome may be diarrhea and rapid breathing. For older children and teenagers the first symptoms may include:
- The child suddenly develops a fever and severe vomiting that is not clearly due to stomach flu.
- Lethargy, sluggishness, lack of energy and loss of interest in surroundings.
- Strange behavior, mental and personality changes.
- Irritability.
- Staring.
- Speech impairment, slurred speech.
- Drowsiness that may lead to severe sleepiness (stupor).
As brain damage progresses, other symptoms may develop, including:
- Impaired skin integrity.
- Hearing loss.
- Double vision.
- Palpitations.
- Confusion and inability to identify whereabouts or family members or to answer simple questions (disorientation).
- Memory lapses.
- Rapid, deep breathing (hyperventilation.
- Unusual belligerence, aggressive behavior, such as hitting others without reason (combativeness).
- Seizures (convulsions), abnormal body positioning.
- Weakness and paralysis in the arms or legs.
- Coma.
- Brain damage.
- Even death may follow if Reye's syndrome is not recognized and treated promptly, usually the result of cerebral edema or respiratory failure.
These signs and symptoms require emergency medical treatment. Fortunately, due to increased awareness of the disease, and especially of the importance of early detection and prompt treatment, the mortality rate has declined to about 20 to 30 percent in recent years.
CAUSE
The exact cause of Reye's syndrome is unknown, but as a result of research conducted in the early 1980s, it is known that the combination of aspirin and viral illness dramatically increases the risk of developing this dangerous disorder. This is why aspirin is no longer recommended for routine use as a pain reliever or fever reducer for children.
The disease most often develops in children who have recently had chickenpox (varicella) or flu (influenza) and who have also taken medications that contain aspirin. Reye's syndrome may be an underlying metabolic condition that is unmasked by a viral illness. Exposure to certain toxins, such as insecticides, herbicides, and paint thinner, also may contribute to Reye's syndrome. Reye's syndrome is not contagious.
The most important step you can take to prevent Reye's syndrome is to avoid giving aspirin or products that contain aspirin to anyone younger than 18-20 years of age unless a health professional has specifically prescribed it.
DIAGNOSIS & TREATMENT
DIAGNOSIS
In general, a diagnosis of Reye's syndrome is considered if:
- Your child has recently had a viral illness such as flu or chickenpox and has taken medication that contains aspirin.
- A change in mental status (such as confusion) is noticed and liver problems are identified.
- There is no evidence to suggest that symptoms are caused by other diseases or conditions, such as kidney failure or problems with metabolism.
LAB TESTS
There's no specific test for Reye's syndrome. Instead, screening for Reye's syndrome usually begins with blood and urine tests. Sometimes more invasive diagnostic tests are needed to evaluate other possible causes of liver problems and investigate any neurological abnormalities.
Lab tests, if needed, include blood and urine tests, a liver biopsy, a CT scan of the head, and a lumbar puncture (spinal tap) to check for infection in the spinal fluid and to measure the pressure of the fluid within the spinal column. Lab tests to diagnose Reye's syndrome include:
- Analysis of blood and urine samples to evaluate liver function and to measure blood sugar (glucose) levels. These tests also help to rule out other medical problems as a cause of symptoms.
- A CT scan (computerized tomography) or MRI (magnetic resonance imaging) of the head to check for an injury or bleeding. This test is used to rule out other causes of behavior changes or decreased alertness. A CT scan uses a sophisticated X-ray machine linked to a computer to produce detailed, 2-dimensional images of the brain. An MRI scan uses magnetic fields and radio waves to generate images of the brain.
- A spinal tap (lumbar puncture) to check for infection in the spinal fluid and to measure the pressure of the fluid within the spinal column. During a spinal tap, a needle is inserted through the lower back into a space below the end of the spinal cord. A small sample of cerebrospinal fluid is removed and sent to a lab for analysis. This test is not specific for diagnosing Reye's syndrome. It is often done to eliminate other causes for the symptoms, such as brain (encephalitis) and spinal (meningitis) infections.
- A liver biopsy, in which a sample of liver tissue is removed for examination under a microscope. A liver biopsy can help the practitioner to identify or rule out other conditions that may be affecting the liver. During a liver biopsy, a needle is inserted through the skin on the upper right side of the abdomen and into the liver. A small sample of liver tissue is removed and sent to a lab for analysis. This is the most accurate test to diagnose Reye's syndrome, although it is not always used because it can cause complications.
Reye's syndrome has become very rare since widespread campaigns publicized the dangers of giving aspirin to young people. In the United States, only two cases of Reye's syndrome were reported each year from 1994 through 1997. Since it is so rare, all other possible causes of brain and liver problems must be eliminated before Reye's syndrome is diagnosed.
CONVENTIONAL MEDICAL TREATMENT
If your child has symptoms of Reye's syndrome, seek medical care immediately. Early diagnosis and treatment increases the chance for full recovery and helps prevent serious complications. If the disease is diagnosed early, most children recover from Reye's syndrome in a few weeks. However, some children may develop serious complications, such as permanent brain damage, or even die if the disease is severe.
The goal of treatment is to stop damage to the brain and liver and to prevent complications. Although Reye's syndrome can range from mild to very serious, all children with it need to be hospitalized, usually in an intensive care unit. During hospitalization, a child:
- May be given fluids by IV through a vein (no fluids by mouth) for several days. Your child may be fed through the IV. Glucose and an electrolyte solution containing sodium potassium and chloride may be given through the IV, too.
- Will have his or her blood pressure, temperature, and pulse (vital signs) monitored very closely.
- May have his or her kidney function checked by having a tube (catheter) placed in the bladder to drain urine into a collection bag.
- Will have blood samples taken frequently to measure the amount of sugar (glucose) and other chemicals in his or her blood. Small amounts of insulin may be used to increase sugar metabolism.
- Will be given medications, such as corticosteroids, to reduce brain swelling.
- Diuretics may be used to increase fluid loss through urination.
If the child becomes seriously ill or is in a coma, treatment will include:
- Monitoring pressure inside the head to help prevent brain damage.
- Using a respirator (ventilator), a type of breathing machine, if the child is having severe difficulty breathing.
Being hospitalized for Reye's syndrome can be a frightening experience for both you and your child. Discuss with the hospital health professionals any questions or concerns you have about your child's care.
- If you are not allowed to stay with your child in the intensive care unit, visit frequently.
- Let your child have some favorite toys or belongings while in the hospital. This will help your child feel more secure.
HOME TREATMENT & PREVENTION
HOME TREATMENT
Home treatment is not appropriate if your child has symptoms of Reye's syndrome. Seek medical care immediately, even if your child has not had a recent viral infection or taken aspirin. Early medical treatment lowers the risk of long-term complications and death.
PREVENTION
You can help prevent Reye's syndrome. Because there is a strong link between the use of aspirin in children and the development of Reye's syndrome, do not give aspirin or products that contain aspirin to anyone younger than 18-20 years of age unless directed by a health professional. This is especially important if the child has chickenpox (varicella) or the flu (influenza).
Aspirin is found in many non-prescription medicines. Read labels carefully before giving a non-prescription medicine, including alternative or herbal remedies, to your child. Aspirin is also called:
- Acetyl salicylate.
- Acetylsalicylic acid.
- Salicylic acid.
- Salicylate or subsalicylate.
These aspirin products are found in Pepto-Bismol, Kaopectate, and Alka Seltzer, for instance.
Certain chronic childhood illnesses, such as juvenile rheumatoid arthritis or Kawasaki disease may require aspirin or aspirin-containing drugs as part of the long-term treatment. Standard medical recommendations are to make sure his or her vaccines are current, including 2 doses of the varicella (chickenpox) vaccine and a yearly flu vaccine. Avoiding these two viral illnesses can help prevent Reye's syndrome. However, give aspirin to a child only with direction from your health professional.
If your child is taking aspirin and gets chickenpox (varicella) or the flu (influenza), contact your health professional immediately.
A child who is hospitalized for Reye's syndrome may take several weeks to recover after returning home. While caring for your child, ask relatives or reliable babysitters to periodically relieve you. Seek recommendations from your health care provider if you need additional help. You will be better able to help your child if you are not overtired.
COMPLICATIONS
More than 80 percent of children and teenagers who have Reye's syndrome survive, although varying degrees of permanent brain damage are possible. Without proper diagnosis and treatment, Reye's syndrome can be fatal within a few days.
RELATED ORGANIZATIONS AND RESOURCES
American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Phone: (847) 434-4000
Fax: (847) 434-8000
E-mail: kidsdocs@aap.org
Web Address: www.aap.org
The American Academy of Pediatrics (AAP) offers a variety of educational materials, such as links to publications about parenting and general growth and development. Immunization information, safety and prevention tips, AAP guidelines for various conditions, and links to other organizations are also available.
National Reye's Syndrome Foundation (NRSF)
426 North Lewis Street
Bryan, OH 43506
Phone: 1-800-233-7393 or (419) 636-2679
Fax: (419) 636-9897
E-mail: nrsf@reyessyndrome.org
Web Address: www.reyessyndrome.org
NUTRITIONAL, HERBAL & HOLISTIC RECOMMENDATIONS
HERBS
The following are herbal remedies that can be useful once the acute phase of the illness has passed and recovery has begun:
Alfalfa, Hawthorn Berry, Hyssop, Milk Thistle, Pau D'Arco, Siberian Ginseng (Eleuthero Root), and Wild Yam help to rebuild and strengthen the liver. Caution: Do not use Siberian Ginseng if you have hypoglycemia, high blood pressure, or a heart disorder.
A lotion containing Aloe Vera, Calendula and/or Chamomile can be used to nourish and heal the skin.
Mountain Rose Herbs: Natural Body & Skin Care Products
Herbal Remedies: Avalon Organics Lotion (With Organic Aloe, Calendula, & Chamomile), Weightless Nourishing Baby lotion For Infants, Children & Sensitive Adults, 6 fl. oz.
Herbal Remedies: Aloe Unscented Hand & Body Lotion, With Calendula & Chamomile, Avalon Organics, 12 fl. oz.
Catnip or Chamomile tea helps to reduce anxiety.
Ginger and Peppermint are good for relief of nausea.
Gravel Root, Hydrangea, Oatstraw, Parsley Root, and Uva Ursi have diuretic properties.
Korean or Chinese Ginseng (Panax ginseng) helps to reduce fatigue. Caution: Do not use this herb if you have high blood pressure.
Herbal Remedies: Panax Ginseng (Korean Ginseng) Herbal Tea, 20 Tea Bags
Herbal Remedies: Red Panax Ginseng, Ultra Strength, 10 ml Vials, 30 Vials
Before administering any herbal supplements, discuss any herbal remedies you wish to use with your health care provider.
Because the main component of the herbs Meadowlark and White Willow Bark are related to aspirin, these should not be given to a child with a fever that may be due to viral illness, including colds, flu, measles, or chickenpox.
MoonDragon's Health & Wellness: Common Cold
RECOMMENDATIONS
Be alert for the following warning signs any time your child is recovering from a viral infection such as a cold, the flu, an ear infection, or chickenpox:
- Prolonged and heavy vomiting, followed by drowsiness.
- Agitation, disorientation, and delirium.
- Fatigue, lethargy, and lapses in memory.
If you have even a suspicion that you or your child may be developing the disease, seek professional medical help at once. Reye's syndrome progresses rapidly and is extremely dangerous. Go to the nearest hospital emergency room immediately and explain the situation.
Be sure that any supplements your child is taking do not contain glutamine, as it can lead to an accumulation of ammonia in the blood. Be aware that although the names glutamine, glutamic acid (also sometimes called glutamate), glutathione, gluten, and monosodium glutamate sound similar, these are all different substances.
If Reye's syndrome is diagnosed, follow your health care provider's recommendations regarding treatment and care, both during the period of hospitalization and afterward, at home.
NEVER give aspirin to a child with a fever or other sign of viral illness. To be safe, many experts recommend against giving children aspirin for any reason. Use acetaminophen (Tylenol, Datril, and others) or ibuprofen (Advil, Nuprin, and others) instead.
CONSIDERATIONS
There is no known cure for Reye's syndrome. Treatment focuses on balancing chemical levels in the blood, while monitoring and supporting the functions of the lung, liver, heart, and brain. The measures that may be taken depend upon the stage of the disease, but treatment almost always involves hospitalization. Typical hospital care include the administration of intravenous fluids to restore blood electrolytes and glucose levels, and sometimes a diuretic to reduce inflammation and to help eliminate waste and excess fluid. In some cases, surgery may be performed to reduce swelling and pressure on the brain.
One way that Reye's syndrome can be detected is through a spinal tap, a procedure that involves inserting a needle into the spinal canal, usually in the lower back, to withdraw a sample of cerebrospinal fluid for examination.
If a person with Reye's syndrome receives an intravenous solution of glucose (sugar) and electrolytes (mineral salts) within 12 to 24 hours after the vomiting starts, the chance of recovery is excellent. This treatment is safe.
The British aspirin industry withdrew all children's aspirin products from the British market a number of years ago in response to the discovery of the link with Reye's syndrome.
A study done by the U.S. Centers for Disease Control & Prevention (CDC) found that 96 percent of the children who had Reye's syndrome had been given aspirin in the presence of a viral illness. The study also indicated a direct correlation between the amount of aspirin taken and the severity of the disease. The makers of aspirin are now required to alert users to the link between aspirin and this potentially life-threatening condition.
NUTRITIONAL SUPPLEMENTS RECOMMENDATIONS
The following supplements are designed for use once appropriate medical measures, including hospitalization, have been taken and recovery has begun. Discuss any supplements with a health care professional before using them. Unless otherwise specified, the recommended doses for the persons age 18 or over. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.
REYE'S SYNDROME SUPPLEMENTS & PRODUCTS
Information, supplements and products for Reye's syndrome, a rare, sometimes serious disease that affects a number of internal organs, including the brain and liver.
Alfa Max, Alfalfa Extract, Nature's Way, 525 mg, 100 Caps
Nature's Way Alfa-Max Alfalfa Extract capsules is a 10x extract of fresh green Alfalfa leaves.Barlean's Flax Oil, Highest Lignan, 1,000 mg, 250 Caps
Barlean's Flax Oil Capsules are the best selling Flax Oil Capsule. Barlean's Flax Oil Capsules are produced from one of the best pure and pristine flax oil providing essential Omega-3 with the highest Lignan content for your good health.Ginger Root, Nature's Way, 550 mg, 180 Caps
Ginger root is especially useful for bowel disorders including indigestion, morning sickness, motion sickness and nausea.Garlic Oil Tincture, Alcohol-Free, Nature's Way, 1 fl. oz.
Garlic oil is often used to soothe the ear and as an antibiotic but most often used as a food and herb and also to lower serum cholesterol and blood pressure and to improve circulation as well as possibly inhibiting the growth of ulcer causing bacteria.Lecithin Fine Vegetarian Granules, 97% Phosphatides, Pure & Fresh, NOW Foods, 1 lb.
Contains Choline & Inositol which are essential for the breakdown of fats and cholesterol. It helps prevent arterial congestion, helps distribute bodyweight, increases immunity to virus infections, cleans the liver and purifies the kidneys.L-Methionine Plus B-6, NOW Foods, 500 mg / 10 mg, 100 Caps
L-Methionine is an essential sulfur amino acid. The body cannot produce L-Methionine, which must be obtained from food or supplement sources.Pau D'Arco (Purple Lapacho), Inner Bark, Nature's Way, 545 mg, 180 Caps
Pau d'arco is a South American herb which helps strengthen and nourish the body's defense system. A healthy immune system is a key in fighting diseases and infections.Pepogest Peppermint Oil, Enteric Coated, Nature's Way, 0.2 ml, 60 Softgels
Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort. Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort.Thisilyn Milk Thistle Extract, Vegetarian, Nature's Way, 175 mg, 100 VCaps
Nature's Way Thisilyn, Milk Thistle Extract, is especially recommended for those who drink, smoke, or are exposed to environmental pollutants.Vitamin A, 100% Natural, Nature's Way, 10,000 IU, 100 Softgels
Nature's Way vitamin A is 100% natural from fish liver oil. It contains no artificial ingredients or preservatives.Vitamin E, Natural D-Alpha-Tocopherol, 400 IU, 100 Softgels
Vitamin E has potent antioxidant activity, supplies oxygen to the blood, aids in strengthening capillary walls, and plays a beneficial role in cancer and cardiovascular disease prevention, anti-aging benefits, circulation, wound-healing, immune function, nervous system function, PMS, hot flushes, diabetes, vascular disease, eye health, tissue repair, athletic performance, leg cramps, skin and hair health, and alleviating fatigue.
Herbal Remedies: Reye's Syndrome Information
Herbal Remedies: Reye's Syndrome Supplements, Information & Products
NOTIFY YOUR HEALTH CARE PROVIDER IF...
Early diagnosis and treatment of Reye's syndrome can save a child's life. If you suspect that your child has Reye's syndrome, it's important to act quickly. Contact your child's health care provider if your child becomes unusually sleepy or lethargic or has sudden behavior changes following a common cold or a bout with the flu or chickenpox. Seek emergency medical help if your child has seizures or convulsions or loses consciousness.
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
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The Complete Guide to Natural Healing
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