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Reye syndrome

Reye syndrome is a rapidly progressive encephalopathy. Symptoms may include vomiting, personality changes, confusion, seizures, and loss of consciousness. Even though liver toxicity typically occurs, yellowish skin usually does not. Death occurs in 20-40% of those affected and about a third of those who survive are left with a significant degree of brain damage.

The cause of Reye syndrome is unknown. It usually begins shortly after recovery from a viral infection, such as influenza or chickenpox. About 90% of cases are associated with aspirin (salicylate) use in children. Inborn errors of metabolism are also a risk factor. Changes on blood tests may include a high blood ammonia level, low blood sugar level, and prolonged prothrombin time. Often the liver is enlarged.

Preventing is typically by avoiding the use of aspirin in children. Following the removal of aspirin for children a more than 90% decrease in cases was seen. Early diagnosis improves outcomes. Treatment is supportive in nature. Mannitol may be used to help with the brain swelling.

The first detailed description of Reye syndrome was in 1963 by Douglas Reye. Children are most commonly affected. It affects less than one in a million children a year. The generally recommendation to use aspirin in children was withdrawn because of Reye syndrome, with use of aspirin only recommended in Kawasaki disease.