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Reye's Syndrome in Children and Teens

By Dr. Heather Zimmerman​, M.D.​​​

​​​Reye's syndrome is a rare but serious condition that can affect children and teens who are recovering from a viral infection such as the flu or chickenpox, or upper respiratory infection like a cold. Do not give your child aspirin while he/she is recovering. Aspirin has been linked with Reye's syndrome, especially in children and teens who have a fatty acid oxidation disorder.

When a child or teen develops Reye's, his/her blood sugar typically drops while levels of ammonia and acidity in the blood rise. At the same time, the liver may swell and develop fatty deposits. The brain may also swell, which can lead to more noticeable symptoms and brain damage.

Initial Signs and Symptoms

In children younger than 2, initial signs of Reye's include diarrhea and rapid breathing during recovery from a viral infection. For children and teens, early symptoms can be persistent and include continuous vomiting and unusual sleepiness/lethargy. As Reye's syndrome progresses, your child may show the following symptoms:

  • Irritable, aggressive or irrational behavior
  • Confusion, disorientation or hallucinations
  • Weakness or paralysis in arms and legs
  • Seizures
  • Excessive lethargy
  • Decreased levels of consciousness

Symptoms typically emerge three to five days after the onset of a viral infection or upper respiratory infection. If your child vomits repeatedly, exhibits unusual lethargy or has sudden behavior changes after suffering from the flu or chicken pox, contact your doctor. You should seek immediate emergency medical help if he or she has seizures or convulsions or loses consciousness.

Tests and Diagnosis

Screening for Reye's begins with urine and blood tests, as well as screening for fatty amino oxidation disorders or other metabolic issues. More invasive tests are needed to investigate any neurological abnormalities and potential causes of liver problems. These may include:

  • A spinal tap or lumbar puncture, to rule out meningitis or encephalitis
  • A liver biopsy, to rule out alternative liver disorders
  • Magnetic Resonance Imaging (MRI) or computerized tomography (CT) scan, to rule out potential causes of behavioral changes or decreased alertness
  • Skin biopsy, to test for fatty acid oxidation disorders

Treatments and Diagnosis

Reye's syndrome is typically treated in the hospital, with severe cases warranting treatment in the intensive care unit. Treatment methods include:

  • Intravenous (IV) fluids, such as a glucose and electrolyte solution
  • Diuretics medications to decrease intracranial pressure and increase fluid loss via urination
  • Medications to prevent bleeding (blood loss due to liver complications may necessitate treatment with plasma, platelets or vitamin K)
  • A ventilator, if your child or teen is having trouble breathing

Most children and teens survive, but there is a risk for varying degrees of permanent brain damage. Without proper diagnosis or treatment, Reye's syndrome can be fatal in just a few days.