Reye syndrome: causes, symptoms, treatment and prevention

Rarely, children who recover from an infectious disease as common as the flu might be, develop into an illness that causes severe changes in their personality and ends up being fatal. They are the victims of the so-called Reye syndrome.

Here are the key aspects of this strange neurological disease which appears to be closely related to the use of aspirin in children.

Discover Reye’s syndrome

When Ralph Douglas Reye, Graeme Morgan and Jim Baral published an article in 1963 in the prestigious medical journal The Lancet describing a picture of encephalopathy and liver damage, they laid the foundation for knowledge of a disease as rare as heterogeneity.

Reye’s syndrome, named after the Australian pathologist who first identified the disease, became diagnosable in 1973, peaking in incidence between 1979-1980.

Clinical description

It is a disease of unknown cause that particularly affects children between 5 and 15 years old.But can manifest itself up to the age of 21 and, very exceptionally, in adulthood.

It usually occurs three to five days after the child has a viral infection. Particularly those which affect the upper respiratory tract, influenza, chickenpox or gastroenteritis, and are linked to the use of aspirin during the infection.

Since there is no specific conclusive proof, the doctor will arrive at the diagnosis clinically, that is to say through the clinical history of the symptoms and with the support of the results which show hepatic damage. Due to the lethality of Reye’s syndrome, it is vitally important to know the early symptoms that characterize the disease. Early diagnosis and treatment can save a child’s life.

Signs and symptoms

In Reye’s syndrome, blood sugar levels drop, while ammonia and blood acidity levels soar. At the same time, the liver can develop fatty deposits. The brain often suffers from edema, causing seizures or loss of consciousness.

The type of symptoms the patient suffers from indicates how advanced the disease is. Depending on their severity, the course can be divided into four stages:

1. Symptoms of stage I

  • Persistent or continuous vomiting
  • dizzy
  • Languor
  • Energy loss

2. Symptoms of stage II

  • irritability
  • aggressive behaviour

3. Symptoms of stage III

  • confusion
  • irrational behavior
  • fighting spirit

4. Stage IV symptoms

  • Delirium
  • convulsions
  • Coma

Unfortunately, the course of Reye’s syndrome is not always the same, and some symptoms may not appear or others may appear instead, making diagnosis difficult. For example, in babies, diarrhea and rapid breathing may appear instead of vomiting, so they do not follow a typical pattern.

Although the presence of vomiting in the absence of infection should already sound certain alarms, loss of consciousness or seizures is a medical emergency that should be treated immediately.

How do we act in case of suspicion?

In most cases, Reye’s syndrome will be treated urgently by healthcare professionals due to neurological symptoms. However, there is a small part that consults with the neurologist before the course worsens.

Preparing for the visit

When the family visits the neurologist, due to the limited time spent on each consultation, it will be very helpful if you have followed these tips to get the most out of your date.

  • Write down any symptoms the child is experiencing in advance.
  • Make a list of all the medications you have taken.
  • Bring another family member or friend.
  • Write down any questions you want to ask the doctor.

It is better to write down the most important questions than the least important, in case you don’t have time to cover them all. Some basic questions that should be asked of the neurologist taking the case are:

  • What are the other possible causes of these symptoms?
  • What tests are needed for diagnosis?
  • What treatments are available and what are the pros and cons of each?
  • What results can I expect?
  • What is the next step?


Once diagnosed with the syndrome, the child will be immediately admitted to an intensive care unit. Treatment is aimed at minimizing symptoms and maintaining vital functions, such as breathing or circulation. It will also be essential to protect the brain from the permanent damage that edema can cause.

The drugs will be given directly into a vein, including: electrolytes and fluids, water pills, ammonia reducing drugs, and anticonvulsants.

Assisted breathing may be necessary if the patient with Reye’s syndrome needs help breathing. Vital signs will be monitored including heart rate, pulse, blood pressureAir circulation and temperature until cerebral edema subsides and bodily functions return to normal.

However, it may take several weeks for the patient to be able to leave the hospital and leave the hospital.


Due to the possible link between the use of aspirin and Reye’s syndrome, these should only be used under the advice of a doctor when the benefits outweigh the risks. Children under the age of 16 should also not take products containing acetylsalicylic acid or salicylic salts, such as certain mouthwashes or toothpastes, as long as there are safer alternatives.

Anyway, it is important to be aware of the symptoms that children experience after an infection, To be able to reach an early diagnosis and avoid damage that might otherwise be permanent.

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