Practical Practitioner
By: Pamela Egan, FNP-C CDE
Reye’s Syndrome linked to aspirin use in children
I treated a 5-year-old in our clinic the other day. She was suffering from Fifth’s Disease, a virus epidemic in the grammar schools right now. Symptoms include high fever, respiratory symptoms, sore throat, slapped cheek appearance, lace-like rash on their arms and trunk, muscle aches and joint pains. Once these kids receive Tylenol or Motrin, their fever goes down temporarily and they’re running and playing again. While obtaining the child’s history, her mother said that she gave her daughter aspirin to lower her fever. We immediately had a discussion regarding Reye’s Syndrome. She had never heard of Reye’s Syndrome.
Because there is a strong link between the use of aspirin in children and the development of Reye’s Syndrome, do not give aspirin or products that contain aspirin to children and teens younger than 20 years of age unless directed by a health professional. This is especially important if the child has chickenpox (varicella), the flu (influenza) or other viral illnesses.
Reye’s Syndrome is a relatively rare disease that primarily affects children under the age of 16. It almost always follows a viral illness like chicken pox, the flu, an upper respiratory tract infection or diarrhea. It is linked to the use of aspirin during the viral illness.
Reye’s Syndrome leads to the rapid development of liver failure and encephalopathy (brain dysfunction) and can be fatal. Symptoms of Reye’s syndrome come on quickly-within a few days to weeks of the viral illness. Symptoms include nausea, vomiting, irritability, agitation, lethargy and confusion and can progress to seizures and coma in very little time.
There is no specific treatment for Reye’s Syndrome. Care usually includes intravenous fluids, breathing support, monitoring of vital signs (temperature, blood pressure, pulse and respiration), blood tests and checking brain function. Whether a child survives Reye’s syndrome depends on the severity of the disease.
Since 1980 parents and caregivers have been advised to avoid giving any aspirin products to children with viral infections to try to prevent Reye’s syndrome. Since that time the number of cases of Reye’s syndrome has dropped dramatically.
Symptoms of Reye’s Syndrome usually start several days after the beginning of a viral infection. Often the child with Reye’s syndrome is getting over a viral infection when symptoms of Reye’s syndrome first appear.
The symptoms develop rapidly over several hours to a day or two and may include:
- – Sudden onset of vomiting that is not clearly due to stomach flu
- – Sluggishness, loss of energy and loss of interest in surroundings
- – Strange behavior, such as staring, irritability, personality change and slurred speech
- – Drowsiness that may lead to severe sleepiness
As the brain becomes more damaged, the following symptoms may develop:
- – Confusion and inability to identify whereabouts or family members or to answer simple questions
- – Rapid, deep breathing
- – Aggressive behavior, such as hitting others without reason
- – Seizures and abnormal body positioning, coma and possibly death
Reye’s disease is diagnosed by medical history, physical exam and lab tests.
There is no cure for Reye’s Syndrome. Treatment is designed to stop brain and liver damage and prevent complications. Early diagnosis and treatment are important to help prevent serious complications and death.
If your child has symptoms of Reye’s Syndrome, seek medical care immediately. In most cases, if the disease is caught early, the illness can be stopped, and the child slowly recovers.
Aspirin may be present in many nonprescription medicines. Read labels carefully before giving a nonprescription medication to your child. Certain childhood illnesses, such as rheumatoid arthritis, may require aspirin as part of the treatment.
However, give aspirin to a child only with direction from your health professional. If your child is taking aspirin and develops a viral illness, contact your health professional immediately.
This article was originally published February 3, 2003 in The St. Tammany News.
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