Reye syndrome

Clinic

• Reye syndrome is a rapidly worsening brain disease.
• Symptoms of Reye syndrome may include vomiting, personality changes, confusion, seizures, and loss of consciousness. While liver toxicity typically occurs in the syndrome, jaundice usually does not. Death occurs in 20–40% of those affected with Reye syndrome, and about a third of those who survive are left with a significant degree of brain damage.

Signs / Symptoms

Reye syndrome progresses through five stages:

• Stage I
  • Vasoconstrictive rash on palms of hands and feet
  • Persistent, heavy vomiting that is not relieved by not eating
  • Generalized lethargy
  • Confusion
  • Nightmares (possible symptom)
  • No fever
  • Headaches

• Stage II
  • Stupor
  • Hyperventilation
  • Fatty liver
  • Hyperactive reflexes

• Stage III
  • Continuation of Stage I and II symptoms
  • Possible coma
  • Possible cerebral edema
  • Rarely, respiratory arrest

• Stage IV
  • Deepening coma
  • Dilated pupils with minimal response to light
  • Minimal but still present liver dysfunction

• Stage V
  • Very rapid onset following stage IV
  • Deep coma
  • Seizures
  • Multiple organ failure
  • Flaccidity
  • Hyperammonemia (above 300 mg/dL of blood)
  • Death

Causes

• 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 in children are associated with aspirin

Entities

• EXT, Eruption, Hand/ Feet
• Hypotonia
• Coma
• Seizure

Miasms

CXA, CXB, ECHO: It is the only full covering miasm