Reye's Syndrome - Diagnosis and Treatment

Reye syndrome is a rare and serious condition that mostly affects children and teens. It can develop quickly, often after a viral infection such as the flu or chickenpox.

The illness impacts the brain and liver, which can lead to severe complications if not treated right away.

Parents and caregivers should know that Reye’s syndrome has become less common due to greater awareness about the risks of giving aspirin to young people.

Diagnosis

Doctors start by looking at signs and symptoms to figure out if a person has Reye’s syndrome. They may look for vomiting, tiredness, confusion, irritability, and sudden changes in behavior like combativeness or delirium.

Other symptoms include fever, seizures, loss of consciousness, muscle weakness, nausea, diarrhea, and even coma. These symptoms often show up in children recovering from a viral illness like the flu or chickenpox.

Because Reye’s syndrome is rare and can mimic other illnesses, doctors take several steps to make a diagnosis.

No single test confirms Reye’s syndrome, so doctors use a series of tests to rule out other causes and check for damage to important organs like the liver and brain.

Common Steps in Diagnosing Reye’s Syndrome:

Test Name	What it Checks For	Why it’s Used
Blood Tests	Liver/organ function, blood chemistry	Detect liver dysfunction
Liver Biopsy	Fatty changes in liver cells	Confirm liver involvement
Spinal Tap	Infection in the brain/spinal cord	Rule out other conditions
CT/MRI Scan	Swelling or brain injury	Check for brain changes

Blood Tests: Doctors check liver function, blood chemistry, and look for substances that build up because the liver isn’t working well.
Urine Tests: Doctors look for metabolic problems or signs of infection.
Liver Biopsy: Doctors remove a small piece of liver and examine it under a microscope to look for fat buildup, a sign of Reye’s syndrome.
Spinal Tap: Doctors take a sample of fluid from around the brain and spinal cord to check for infections like meningitis or encephalitis, which can look similar to Reye’s syndrome.
Brain Scans (CT or MRI): Doctors use these images to check for swelling (cerebral edema) or other problems. Swelling in the brain can lead to confusion, seizures, weakness, or even paralysis.

Doctors may also check for inborn errors of metabolism or fatty acid oxidation disorders if a child has symptoms of liver dysfunction or unexplained brain damage.

Doctors use this information, along with a detailed history of recent viral infections and any aspirin use, to decide if a person likely has Reye’s syndrome. Each test helps rule out other possible causes for the symptoms.

Treatment

Treatment for Reye’s syndrome takes place in a hospital, often in an intensive care unit for serious cases. Medical staff carefully check blood pressure, heart rate, and breathing.

Common treatment options include:

IV Fluids: Medical staff provide sugar (glucose) and salts (electrolytes) by vein to keep the body balanced.
Diuretics: Doctors use these to help remove extra fluid and lower pressure on the brain.
Medicines for Bleeding: Medical staff administer vitamin K, plasma, or platelets if liver problems cause bleeding.
Cooling Blankets: Medical staff use these to keep body temperature safe.

A ventilator can help with breathing if needed. Insulin and steroids are not always used for Reye’s syndrome, and doctors adjust treatments based on the child’s condition.

Getting Ready for Your Visit

Steps You Can Take Ahead of Time

Being prepared for a healthcare visit is important when a child shows symptoms that could be related to Reye’s syndrome.

Here are ways families can help appointments run smoothly and make sure important information is shared with the care team:

Check for any instructions before arriving. Some clinics or specialists may ask for things like fasting before tests or bringing recent medical records. Check with the office at the time you book so nothing is missed.
Make a full list of symptoms. Write down every symptom your child has, even if it seems unrelated. Include when symptoms started and how they have changed over time. This can help the doctor recognize patterns.
Gather all medications and supplements. Create a list of all medicines, vitamins, or supplements your child has taken recently. This is very important for medicines containing aspirin or other salicylates, as they should not be used in children with viral illnesses due to the risk of Reye’s syndrome. Putting the actual medicine bottles in a bag to take with you can be helpful.
Bring a support person. Appointments can feel overwhelming, especially when a child is unwell. Taking along a trusted adult can help. This person can ask questions, take notes, and recall the doctor’s instructions.
Prepare questions in advance. Write down questions you want answered. This can help you remember to discuss every topic that matters to your family during the visit. It helps to list questions in order of importance to make the best use of your time.
Sample questions for the doctor:
- What could be causing my child’s symptoms?
- What tests will confirm or rule out Reye’s syndrome?
- What treatments do you recommend, and what are the risks and benefits?
- What side effects should we watch for with these treatments?
- How should we prevent Reye’s syndrome in the future?
- Will there be follow-up care or more tests?
Be ready to ask new questions. As the visit goes on, something the doctor says may lead to new questions. It’s always okay to bring these up.

Below is a table to help families track important information before their visit:

Information to Collect	Why It Matters
List of all symptoms	Helps the doctor understand the illness.
Recent medications (name, dose)	Reveals possible use of aspirin/salicylates.
Details about recent viral infections	Some viruses increase Reye’s syndrome risk.
Family medical history	May help in diagnosis and plan of care.
List of questions	Ensures nothing is missed during the visit.

Always avoid giving aspirin or any medicine with salicylates to children or teens recovering from viral infections like flu or chickenpox. This step is crucial in preventing Reye’s syndrome.

Topics Your Doctor Will Likely Cover

The specialist, often a neurologist, usually begins by asking about your child’s symptoms in detail. Questions might include:

What were the first signs, and when did they start?
Has your child had any recent viral illnesses, such as the flu or chickenpox?
Has your child taken any medicines that contain aspirin or salicylates?

A physical examination often comes next. The doctor checks your child’s general health and looks for specific signs that point to Reye’s syndrome or other medical problems.

Sometimes, blood tests, urine tests, or scans are requested. These tests can help confirm Reye’s syndrome or rule out conditions like meningitis or encephalitis.

Doctors know that Reye’s syndrome can progress quickly, so they may order tests and treatments right away. They may ask questions about home remedies, over-the-counter medicines, and past medical problems.

You can expect the doctor to discuss steps you can take to reduce your child’s risk in the future. For example, they will explain why aspirin and other salicylate medicines should be avoided.

Doctors may also tell you about signs and symptoms to look for after you leave the clinic, and when to seek help again.

Your doctor wants you to understand each part of your child’s care. They encourage you to ask questions if you don’t understand something. It can help to ask for explanations in simple terms and to repeat back what you learned.

Taking notes or asking for instructions in writing is a good idea. Below is a list of what might happen when meeting with the specialist:

The doctor will ask about your child’s current and past health.
They may order immediate testing.
Treatments may start if Reye’s syndrome is strongly suspected.
You will be given information on what signs should prompt an urgent return to the doctor.
The doctor will provide guidance to avoid aspirin and salicylates for children and teenagers in most cases, especially during or after viral illnesses.

Having the right information ready and knowing what to expect can help make your child’s healthcare visit more effective and less stressful.

Reye’s Syndrome – Diagnosis and Treatment