Approach

The diagnosis of Reye's syndrome is usually made based on history and laboratory testing. Reye's syndrome should be considered in any child presenting with profuse, protracted vomiting and altered mental status, ranging from personality changes to coma. Data from the US suggest that Reye's syndrome mainly affects white children aged 5 to 14 years.[5]

There is no definitive test to confirm the diagnosis of Reye's syndrome. Because Reye's-like illnesses can be caused by many different disease entities, a low threshold for the diagnosis of Reye's syndrome should aid in quickly ruling in or out other aetiologies. Any patient in whom the diagnosis of Reye's syndrome is suspected should undergo additional investigations for inborn errors of metabolism in consultation with a geneticist, a gastroenterologist, and other specialists as appropriate.

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