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Tuesday, April 10, 2007

Reye's Syndrome

What is Reye's syndrome?

Since 1986, aspirin manufacturers have been required to include a warning on product labels advising against giving the drug to children for chicken pox or flu symptoms. But to be on the safe side — since you can never know for sure whether a virus is causing your toddler's symptoms — never give your child aspirin for any reason.

Reye's syndrome can strike anyone at any age, but it usually affects children between the ages of 4 and 12. And while it can occur anytime of year, rates are highest during the flu season months of January, February, and March.

In part because it's so uncommon, Reye's is often misdiagnosed. For example, it may be mistaken for encephalitis, meningitis, diabetes, a drug overdose, or poisoning.

Reye's affects all the organs of the body but causes the gravest harm to the liver and the brain. If left untreated, the disease can quickly lead to liver failure, brain damage, and even death.

The cause of RS remains a mystery. However studies have shown that using aspirin or salicylate-containing medications to treat viral illnesses increases the risk of developing RS. A physician should be consulted before giving a child any aspirin or anti-nausea medicines during a viral illness, which can mask the symptoms of RS.

If you think your child may have Reye's syndrome, consider it a medical emergency and call his doctor right away, take him to the emergency room, or call 911. An early diagnosis can significantly improve a child's chances of surviving.

What are the symptoms of Reye's Syndrome?

The symptoms of Reye's syndrome can appear during a viral illness, but they more commonly show up one to two weeks later. A child with Reye's syndrome may or may not have a fever. Other symptoms often develop in stages.

The first sign is usually persistent vomiting. Other early symptoms may include diarrhea, listlessness, drowsiness, and lethargy

As the disease progresses and affects the brain, a child may become agitated, hyperactive, and combative. He may become delirious, have a convulsion or a seizure, and could slip into a coma. If he doesn't receive treatment, he may die.

Of course, a child with other, less serious, illnesses may have some of these symptoms, too. And few children will have Reye's syndrome, as the United States reports only about 50 cases per year. Still, because early treatment is so important, you'll want to be cautious.

Is there any treatment?
There is no cure for RS. Successful management, which depends on early diagnosis, is primarily aimed at protecting the brain against irreversible damage by reducing brain swelling, reversing the metabolic injury, preventing complications in the lungs, and anticipating cardiac arrest. It has been learned that several inborn errors of metabolism mimic RS in that the first manifestation of these errors may be an encephalopathy with liver dysfunction. These disorders must be considered in all suspected cases of RS. Some evidence suggests that treatment in the end stages of RS with hypertonic IV glucose solutions may prevent progression of the syndrome.

What is the prognosis?

Recovery from RS is directly related to the severity of the swelling of the brain. Some people recover completely, while others may sustain varying degrees of brain damage. Those cases in which the disorder progresses rapidly and the patient lapses into a coma have a poorer prognosis than those with a less severe course. Statistics indicate that when RS is diagnosed and treated in its early stages, chances of recovery are excellent. When diagnosis and treatment are delayed, the chances for successful recovery and survival are severely reduced. Unless RS is diagnosed and treated successfully, death is common, often within a few days.

How can I protect my toddler from Reye's syndrome?

Not giving your toddler aspirin is your best defense. What causes the disease is unknown, but research shows that aspirin or medications that contain aspirin can trigger the disease in a child who has had a virus or just recovered from one. In fact, 90 to 95 percent of Reye's syndrome patients in the United States took aspirin during a recent viral illness.

Reye's syndrome isn't contagious, so you don't have to worry about your toddler catching it.

To safeguard your toddler's health, take the following precautions:

Never give aspirin to your child — or to anyone 19 years old or younger. Instead, keep acetaminophen or ibuprofen on hand to relieve pain and fever.

Read labels carefully to avoid accidentally giving your toddler aspirin: Many over-the-counter drugs, such as antacids and cold and sinus medicines, contain aspirin. Be on the lookout for the terms like salicylate, acetylsalicylate, acetylsalicylic acid, salicylamide, and phenyl salicylate, which may be used instead of the word aspirin.

Where can I get more information?

If you're in the United States, contact the National Reye's Syndrome Foundation at (800) 233-7393.

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