Reye's syndrome

Last reviewed: 26 Aug 2022
Last updated: 05 May 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • vomiting
  • altered mental status
More key diagnostic factors

Other diagnostic factors

  • hyperventilation
  • hepatomegaly
  • abnormal pupillary response
  • hyper-reflexia/areflexia
  • diminished pain response
  • seizures
  • absence of, or minimal, jaundice and scleral icterus
Other diagnostic factors

Risk factors

  • age 5-14 years
  • white ethnicity
  • recent viral infection
  • aspirin (acetylsalicylic acid) and other drug exposure
  • genetically predisposed individual
  • toxin exposure
  • winter/spring presentation
More risk factors

Diagnostic investigations

1st investigations to order

  • serum electrolytes
  • serum glucose
  • LFTs
  • serum ammonia
  • PT/PTT
  • urine/serum toxicology
  • urinalysis
  • blood gas
More 1st investigations to order

Investigations to consider

  • cranial CT
  • lumbar puncture with cerebrospinal fluid analysis
  • EEG
  • liver biopsy
  • metabolic testing
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Vanessa G. Carroll, MD, FAAP

Medical Director of Pediatric Hospital Medicine

Kootenai Health

Coeur d’Alene

ID

Disclosures

VGC declares that she has no competing interests.

Russell W. Steele, MD, FAAP

Section Head of Pediatric Infectious Diseases

Ochsner Medical Center for Children

New Orleans

LA

Disclosures

RWS declares that he has no competing interests.

Acknowledgements

Dr Vanessa G. Carroll and Dr Russell W. Steele would like to gratefully acknowledge Dr Barry M. Starr, a previous contributor to this topic. BMS declares that he has no competing interests.

Peer reviewers

William F. Balistreri, MD

Professor of Pediatrics

Cincinnati Children's Hospital Medical Center

Cincinnati

OH

Disclosures

WFB declares that he has no competing interests.

Bernard Portmann, MD, FRCPath

Consultant Histopathologist

Institute of Liver Studies

King's College Hospital

London

UK

Disclosures

BP declares that he has no competing interests.

  • Differentials

    • Head injury
    • Acute bacterial meningitis
    • Viral meningitis
    More Differentials
  • Guidelines

    • Management of children and young people with an acute decrease in conscious level
    • Reye syndrome: 1990 case definition
    More Guidelines
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