Overview

A rare systemic disease, generally affecting children between ages of 4-12 years, but up to 18 years of age. It is characterised by an acute noninflammatory encephalopathy with fatty liver failure.

Symptoms and Signs

• Persistent vomiting
• Confusion
• Lethargy
• Disorientation
• Hyperreflexia
• Tachypnoea
• Tachycardia

Rapid progression to seizures, non-inflammatory encephalopathy, coma and even death from associated cerebral oedema.

Hepatomegaly, acute hepatic steatosis, fatty liver degeneration and multiple laboratory abnormalities are associated.

Risk factors

Develops between 12h to 3 weeks after recovery from viral illness - usually URTI or gastrointestinal virus.

Most common viruses associated include influenza A, B or chickenpox. Other less common viral associations include parainfluenza, coxsackie, EBV, CMV, adenovirus.

Bacterial pathogens such as Chlamydia, Bordetella pertussis, Mycoplasma, and Shigella have also been associated with the development of Reye syndrome.

Epidemiologic studies found a link between use of salicylate and development of Reye syndrome. While less than 0.1% of children who took aspirin developed Reye syndrome, more than 80% of children diagnosed with Reye syndrome had taken aspirin in the preceding 3 weeks.