Reye’s syndrome is a rare non-inflammatory disease that can cause serious damage to the liver and brain. If the disease is not treated quickly, it can cause irreversible brain damage or even be lethal for the individual.

The subjects most often affected by Reye’s syndrome are children and young adults under the age of 20. However, cases of older adults have already been identified. (1)

The prevalence of this pathology in France (number of cases of the disease at a given time, in a given population) amounts to 0.08 cases per 100 children.

A cause and effect link has been put forward in the United States when taking aspirin and the development of Reye’s syndrome.

This correlation was then evaluated in France (between 1995 and 1996). The latter allowed the census of 8 children under 15 years of age suffering from this syndrome and taking aspirin. The questioning of the benefit / risk ratio of aspirin was nevertheless not effective despite a warning. This particular attention to the prescription of aspirin concerns children with viral diseases, such as chickenpox, influenza, etc.

In this sense, the ANSM (National Agency for Health and Medicines) has established the fact that acetylsalicylic acid (aspirin) should not be administered to children suffering from this type of virus unless all other measures have failed. . In addition, in the event of vomiting, neurological disorders, disturbances of consciousness or abnormal behavior, this treatment must be discontinued. (3)

The symptoms most commonly associated with Reye’s syndrome are: (1)

– vomiting for no underlying reason;

– indolence: lack of interest, enthusiasm and energy;

– drowsiness;

– increased breathing;

– epileptic seizures.

These “general” symptoms often appear only a few days after the viral infection.

In some cases, these early symptoms can progress to more severe ones: (1)

– personality disorders: irritability, agitation, aggressive behavior, etc. ;

– a state of confusion and anxiety which can sometimes be associated with hallucinations;

– loss of consciousness which can lead to a coma.

The consultation of a doctor must be early dice the suspicion of this syndrome in the child.

Although these types of symptoms are not necessarily associated with Reye’s syndrome, it is necessary to verify the hypothesis in order to confirm or not the development of the pathology. In this case, it is imperative to warn the doctor of the possible intake of aspirin in childhood which may be linked to the development of this syndrome. Moreover, if the child has not had a prescription for aspirin intake previously, the possibility of the development of the disease can be excluded. (1)

The exact origin of Reye’s syndrome is currently unknown. However, most cases of the disease concern children and young adults (under the age of 20) recovering from a viral infection, and more particularly influenza or chickenpox. In addition, these patients had a prescription for aspirin in the treatment of this viral infection. In this sense, the treatment with aspirin of a virosis makes it the most often found cause.

 An additional element in the development of this pathology results in small structures inside the cells: the mitochondria, which are damaged.

These cellular structures provide the energy required for cell development. They are particularly important for the proper functioning of the liver. Indeed, mitochondria also filter toxins from the bloodstream and are also involved in the regulation of blood sugar (sugar levels) in the body.

In the context where these hepatic regulatory processes are impacted, the liver can be destroyed. Liver destruction results from the production of toxic chemicals. By passing through the bloodstream, these toxins can damage the whole organism and more particularly the brain. (1)

Other illnesses can also be the cause of the symptoms associated with Reye’s syndrome. In this sense, the diagnosis of this type of syndrome can be ruled out under certain circumstances. These other pathologies include:

– meningitis: inflammation of the protective membranes covering the brain and spinal cord;

– encephalitis: inflammation of the brain;

– diseases grouping together metabolic disorders impacting the chemical reactions of the organism. The most common is: acyl-CoA medium chain dehydrogenase (MCADD).

The main risk factor for Reye’s syndrome is mainly taking aspirin when treating a flu-like viral infection or chickenpox in children or young adults.

The diagnosis of this disease begins with a differential diagnosis in view of the symptoms presented by the patient as well as his history, in particular concerning the intake of aspirin during the treatment of a viral infection.

Blood and urine analysis can also allow the diagnosis of Reye’s syndrome in the sense that the toxins characteristic of the pathology can be found in these body fluids. The presence of these harmful substances for the body is a source of abnormal liver function.

Other tests can also be the object of the demonstration of the syndrome:

– the scanner, making it possible to highlight any swelling in the brain;

– a lumbar puncture, during which a sample of cerebrospinal fluid is taken from the spinal cord and analyzed in order to check for the possible presence of bacteria or viruses;

– a liver biopsy, in which a sample of the liver tissue is taken and examined under a microscope to determine the presence or absence of cells associated with Reye’s syndrome.

Treatment of the disease must be implemented as soon as the diagnosis is made.

The aim of treatment is to minimize symptoms and allow vital organs to perform their functions as well as protect the brain from possible damage that the disease can cause.

A large number of drugs can be administered, usually intravenously, such as:

– electrolytes and fluids, making it possible to restore the balance of salts, minerals and nutrients in the body (especially glycemia in the bloodstream);

– diuretics: to help the liver in its functioning;

– ammonia detoxifiers;

– anticonvulsants, in the treatment of epileptic seizures.

Respiratory aid may also be prescribed in the setting where the child has difficulty in his breathing.

Once the swelling in the brain subsides, the body’s other vital functions usually return to normal. (1)