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Reye's syndrome.

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 disorded brain function, such as staring spells, stupor, delirium or strange behavior, a medical examination should be made promptly.

Vomiting on the first day of illness, especially when there is also diarrhea, is usually NOT due to Reye's Syndrome. In such cases, the children are usually alert and active. They may be suffering from acute infectious gastroenteritis.

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 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; developes 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 should 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 (acetyl-salicylic acid), or sodium or bismuth salicyclates. Below is a list of medications which contain salicylates:
Pepto Bismol
Alka-Seltzer plus
Coricidin "D"
Dristan Tablets
Sine-Off Sinus Medicine
Coricidin Medilets
Anacin Maximum Strength
Coricidin Demilets
4-Way Cold Tablets
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.
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Publication:Pamphlet by: American Liver Foundation
Article Type:pamphlet
Date:Sep 23, 1991
Previous Article:Alpha 1-antitryosin deficiency.
Next Article:Primary sclerosing cholangitis.

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