Introduction to Reye’s syndrome

Reye’s syndrome can appear soon after a viral infection, especially a flu-like illness or chickenpox. It's is a very rare disorder which affects children and young people. Unless diagnosed and treated successfully, death or severe disability may result.

The child has a change in his/her personality or becomes drowsy or unconscious and develops frequent or persistent effortless vomiting.

The disease affects children from infancy onwards, including teenagers, and has been reported, albeit rarely, in older adults. Children of both sexes and all races can be affected.

There is disordered liver function with raised serum hepatic transaminases and hyperammonaemia without hyperbilirubinemia.

There is often hypoglycaemia and disordered clotting.

Abnormal accumulations of fat develop in the liver and some other organs of the body.

There is also cerebral oedema which may cause permanent brain injury or death if treated inadequately.

Key points

  • Reye’s syndrome can appear soon after a viral infection, especially a flu-like illness or chickenpox.
  • Early signs of Reye’s syndrome are continuous vomiting, listlessness, drowsiness, irritability, confusion, irrational behaviour, a convulsion or coma.
  • In patients with the signs and symptoms described above, abnormal liver function tests, including raised blood ammonia, strongly suggest a diagnosis of Reye’s syndrome or a “Reye-like” inherited metabolic disorder.
  • Inherited metabolic disorders can present as a “Reye-like” disorder especially in children under 4 years. It is essential to diagnose them because of implications for genetic counselling, specific treatment and investigation of other children in the family.
  • Medicines can mask symptoms. Therefore a patient developing any of the symptoms of Reye’s syndrome, should not be given anti-nausea or fever reducing medicine.
  • Children and young persons under 16 should not take or be given aspirin unless clinically indicated, for example as specific anti-inflammatory or anti-platelet therapy or the treatment of Kawasaki disease.
  • Reye’s syndrome has been reported in children and teenagers, and albeit rarely, in adults.

Early diagnosis and appropriate treatment is vital.

Date of next review: December 2021