When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Reye syndrome

Last reviewed: 10 Sep 2024
Last updated: 19 Apr 2023

Summary

Definition

History and exam

Key diagnostic factors

  • vomiting
  • altered mental status
Full details

Other diagnostic factors

  • hyperventilation
  • hepatomegaly
  • abnormal pupillary response
  • hyperreflexia/areflexia
  • diminished pain response
  • seizures
  • absence of, or minimal, jaundice and scleral icterus
Full details

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
Full details

Diagnostic tests

1st tests to order

  • serum electrolytes
  • serum glucose
  • LFTs
  • serum ammonia
  • PT/PTT
  • urine/serum toxicology
  • urinalysis
  • blood gas
Full details

Tests to consider

  • cranial CT
  • lumbar puncture with cerebrospinal fluid analysis
  • EEG
  • liver biopsy
  • metabolic testing
Full details

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
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer