Reye's Syndrome: Down But Not Out

Adnan T. Bhutta, MBBS, Van H. Savell, MD, Stephen M. Schexnayder, MD


South Med J. 2003;96(1) 

In This Article

Abstract and Introduction

Reye's syndrome presents as acute central nervous system and liver dysfunction in children. Its incidence has seen a sharp decline in parallel with the decline in the use of aspirin in the pediatric age group. This report describes a patient with Reye's syndrome and serves as a reminder for health professionals to continue to discourage the use of aspirin for the treatment of viral infections.

Reye's syndrome was first described as a separate clinical entity by Reye et al[1] in 1963. It is characterized by acute encephalopathy and hepatopathy with characteristic anatomic and biochemical changes,[2] and predominantly affects children. After reaching an incidence of 400 to 600 cases per year in the United States in the 1970s and early 1980s, the incidence had decreased to approximately two cases per year by 1997.[3] This decline has been attributed to the sharp decrease in the use of aspirin for treating children.[3,4] Another reason for this decline may be improvement in the diagnosis of metabolic diseases, such as medium-chain acyl-coenzyme A dehydrogenase deficiency, that cause illnesses similar to Reye's syndrome.[5] A MEDLINE search revealed no new reported cases in the United States since 1997. This dramatic disappearance of a once-feared childhood illness is considered a public health triumph because of the concerted effort by health care professionals and government agencies to educate the public about the probable role of aspirin in Reye's syndrome.[6] The almost complete disappearance of this disease, however, poses the danger that public awareness of its epidemiologic link with aspirin will decline and lead to reemergence of this problem. We report one such case.