Reyes syndrome

Reye syndrome is a rare disorder in children, characterized by a combination of severe liver disorder and encephalopathy (central nervous system (CNS) disturbances) that can follow an acute viral illness and which has a relatively high mortality. It has been found to be... 

Aspirin is associated with Reyes syndrome, a disease of the brain that may arise in children recovering from chicken pox. What alternatives to aspirin might be used to relieve pain and fever in children recovering from this virus ... 

Suggested Alternatives for Differential Diagnosis Bartonellosis, brucellosis, other causes of encephalitis, coxsackieviruses, cryptococcosis, cysticercosis, cytomegalovirus, histoplasmosis, legionellosis, leptospirosis, listeria, lyme disease, malaria, rabies, tuberculosis, mumps, stroke, metabolic encephalopathy, Reye syndrome, Bartonella infection, Naegleria infection, Ebstein-Barr virus, prion disease, toxic ingestions, and AIDS. 

Reye syndrome Do not use in children or teenagers with viral infections with or... 

Use in children - Contraindicated in children younger than 2 years of age because of the potential for fatal respiratory depression. The extrapyramidal symptoms that can occur secondary to promethazine administration may be confused with the CNS signs of undiagnosed primary disease (eg, encephalopathy, Reye syndrome). Avoid use in children whose signs and symptoms may suggest Reye syndrome or other hepatic diseases. TRIPROLIDINE HYDROCHLORIDE ... 

Antiemetic effects Drugs with antiemetic effect can obscure signs of toxicity of other drugs, or mask symptoms of disease (eg, brain tumor, intestinal obstruction, Reye syndrome). They can suppress the cough reflex aspiration is possible. 

This condition is sometimes mistaken for Reye syndrome, a severe disorder that develops in children while they appear to be recovering from viral infections such as chicken pox or flu. Most cases of Reye syndrome are associated with the use of aspirin during these viral infections. 

Although the use of aspirin in treating fever in children is contraindicated (because of the association with Reye syndrome see Problems and Adverse Effects of Aspirinlike Drugs ), aspirin remains the primary NSAID used in treating fever in adults.9 Ibuprofen is also used frequently as a nonprescription antipyretic NSAID in both adults and children. 

Casteels-Van Daele M, Van Geet C, Wouters C, Eggermont E. Reye syndrome revisited a descriptive term covering a group of heterogeneous disorders. Eur JPediatr. 2000 159 641-648. 

Brown, J.K., Imam, H. Interrelationships of liver and brain with special reference to Reye syndrome. X. Inher. Metabol. Dis. 1991 14 436-458... 

Fox DW, Hart MC, Bergeson PS, Jarrett PB, Stillman AE, Huxtable RJ. Pyrrohzidine Senecio) intoxication mimicking Reye syndrome. J Pediatr 1978 93(6) 980-2. 

Casteels-Van Daele M. Reye syndrome or side-effects of anti-emetics Eur J Pediatr 1991 150(7) 456-9. 

Bismuth Subsalicylate (Pepto-Bismol) Acts directly on the gastric mucosa, do not give to children due to risk for Reyes syndrome... 

Original Mothers concerned about the possibility of Reyes syndrome should avoid giving aspirin to their sick children. 

R, Rothbaum R> et al. Grade I Reyes syndrome. A frequent cause of vomiting and liver dysfunction after varicella and upper-respiratory-tract infection. 

Contraindication in a susceptible subpopulation Aspirin (acetylsalicylic acid) has been associated with the occurrence of Reye syndrome and, as a result, the Committee on Safety of Medicines has advised that aspirin-containing preparations should not be given to children and adolescents under 16 years of age unless specifically indicated, for example for Kawasaki syndrome. Establishing this contraindication, relating to what is probably the most widely used medicine known, involved educating the whole community and represented one of the most remarkable therapeutic achievements of the late twentieth century. The... 

When ammonia is found in biological materials at physiological pH (7.2), most of it (99%) will be found as ammonium ion, due to its pK of 9.2. This is an important consideration for any subsequent analysis. The determination of ammonia (as dissolved NH3 and ammonium ion) in blood, plasma, or semm is of value in detecting existing or impending hepatic coma and Reyes Syndrome (Meyerhoff and Robins 1980 Tietz 1970). The determination of ammonia in urine had historically been used as an indicator of the kidney s ability to produce ammonia however, this procedure has been replaced by more modem and accurate tests for kidney function. Procedures for the determination of ammonia in biological samples are found in Table 7-1. Ammonia is also tested for in calculi (abnormal concretions in the body formed of mineral deposits, often found in the gall bladder, kidney, or bladder) (Tietz 1970) however, this is not a quantitative test and is not included in Table 7-1. 

Young children are gustatory explorers. Among the compounds responsible for toxicity in youngsters under the age of 3 years are three items commonly found in households with tots" aspirin, acetaminophen (people know about Reye syndrome ), and supplementary iron tablets. 

Besides cultural differences, there are also ethnic and racial differences in the physiological response to dmgs. As you ll recall from Chapter 2, pharmacogenetics is the study of the influence genetics have on a drug response. For example children with Reyes Syndrome, which is a hver disease, cannot metabolize aspirin because of a genetic defect. 

Precautions An allergen. May cause bleeding. A 10 g dose may be fatal. Sometimes prescribed to prevent heart attacks because of anticoagulant action. Recent studies indicate it may be a colon cancer preventative. Should be avoided before surgical procedure to avoid excessive bleeding. Should not be taken by children because of Reyes syndrome implication. 

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