A recently
recognized childhood disease, Reye's Syndrome is a rare complication of
common childhood respiratory infections, including chickenpox.
Reye's
Syndrome should be suspected when vomiting begins 3 to 7 days after
the onset of flu or chickenpox. Usually the vomiting becomes increasingly
severe over a period of 8 to 12 hours. When there is persistent vomiting
lasting more than 12 hours following 3-7 days after a flu-like illness
or chickenpox, the child should be examined and tested for Reye's Syndrome.
If the vomiting is associated with signs of disordered brain function,
such as staring spells, stupor, delirium or strange behavior, a medical
examination should be made promptly.
Although Reye's Syndrome can occur at any time, it is most frequent
during January, February and March, in association with influenza and
similar respiratory infections. About one-third of the cases of Reye's
Syndrome occur as a complication of chickenpox, usually 3 or 4 days
after the rash appears.
Reye's
Syndrome is most common in school-aged children and teenagers, but cases
also occur in infants. The illness is rare in adults.
There
is an excellent chance of recovery when Reye's Syndrome is diagnosed
and treated early, before delirium or coma has developed. Children who
are not diagnosed early may lapse into a coma and die.
Early
signs of Reye's Syndrome are: persistent vomiting, beginning 3 to 7
days after flu or chickenpox; indications of brain disorder: listlessness,
staring, and drowsiness.
In
the later stage, the child shows personality changes, such as aggressive
behavior and disorientation; becomes confused; has slurred speech; develops
agitated delirium with screaming and struggling, and may not recognize
parents. This stage is a medical emergency.
Diagnosis
of the early stage of Reye's Syndrome can be achieved by combining:
history of previous flu-like illness; persistent vomiting, elevation
of serum SGPT with a normal bilirubin and exclusion of meningitis, encephalitis,
etc.
Almost
all cases of Reye's Syndrome have increased serum concentrations of
certain liver enzymes. One of these is called serum glutamic pyruvic
transaminase (SGPT). Every hospital emergency room physician who evaluates
children should be able to measure the SGPT on an emergency basis. When
there is an elevation of this enzyme associated with unexplained vomiting,
the child would be admitted to the hospital and treated with intravenous
fluids. It is believed that aspirin may contribute to the problem of
Reye's Syndrome. Until conclusive evidence is obtained, doctors advise
against the use of aspirin in chickenpox and during outbreaks of influenza-like
disease. Many over-the-counter remedies contain aspirin (acetylsalicylic
acid), or sodium or bismuth salicylates. Below is a list of medications
which contain salicylates:
- Pepto
Bismol
- Coricidin
- Medilets
- Triaminicin
- Excedrin
- Alka-Seltzer
- Aspergum
- Anacin
- Anacin
Maximum Strength
- Coricidin
- Coricidin
Demilets
- Dristan
Tablets
- 4-Way
Cold Tablets
- Bufferin
- Bufferin
Extra-Strength
Acetaminophen (Tempra, Tylenol) is the preferred antifever medicine
during chickenpox, flu and at rare times when Reye's Syndrome is prevalent
in the community.
The
American Liver Foundation is the only national voluntary health organization
dedicated to preventing, treating, and curing hepatitis and all other
liver and gallbladder diseases through research and education.
American Liver Foundation
1425 Pompton Avenue, Cedar Grove, NJ 07009
1-800-223-0179
Copyright
© 1995
The American Liver Foundation
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