Reye Syndrome and Aspirin

Here we describe a case of Reye syndrome diagnosed at postmortem liver biopsy of a three-year oldgirl who presented with vomiting, low grade fever for three days and loss of consciousness for 18hours. Clinically, the differential diagnoses were meningitis, encephalitis and septicemia. No historyof past illness or any drug ingestion including aspirin were present. Laboratory investigationsindicated a diagnosis of Reye syndrome. The child was given supportive treatment but died aftertwo days of admission and postmortem needle-biopsy of the liver showed microvesicular steatosisconsistent with Reye syndrome.Key words: Microvesicular steatosis, mitochondrial hepatopathy, Reye syndrome, Reye-like syndrome

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Kawasaki Syndrome, Reye Syndrome, and Aspirin

PEDIATRICS ◽

10.1542/peds.77.4.617 ◽

1986 ◽

Vol 77 (4) ◽

pp. 617-617

Author(s):

MARTHA BUSHORE

Keyword(s):

Airway Resistance ◽

Platelet Adhesion ◽

Therapeutic Benefit ◽

Kawasaki Syndrome ◽

Reye Syndrome ◽

Optimal Outcome ◽

Appropriate Use ◽

Excellent Review ◽

Pediatric Diseases

In Reply.— Because the incidence of each of these serious pediatric diseases is low, but the need for prompt recognition and skillful management is essential to optimal outcome, Drs Takahashi and Mason's excellent review and knowledgeable guidance are invaluable to the practicing pediatrician who rarely manages either of these disorders. Our concern that aspirin may interfere with platelet adhesion (when not therapeutically desirable), may increase airway resistance, and may be associated with Reye syndrome should not lead us to discontinue recommending appropriate use of this excellent drug when therapeutic benefit outweighs risk.

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Hepatic Monoamine Oxidase Deficiency in Reye Syndrome

PEDIATRICS ◽

10.1542/peds.65.3.673 ◽

1980 ◽

Vol 65 (3) ◽

pp. 673-673

Author(s):

Robert A. Mitchell ◽

Edgardo L. Arcinue

Keyword(s):

Monoamine Oxidase ◽

Oxidase Activity ◽

Reye Syndrome ◽

Disruptive Effect ◽

Monoamine Oxidase Activity ◽

Reye's Syndrome ◽

Oxidase Deficiency ◽

Mitochondrial Injury ◽

Subsequent Decrease

Faraj et al1 recently reported a positive correlation between plasma tyramine levels and the number of days in coma, for patients with biopsy-proven Reye's syndrome. They suggested that the mitochondrial injury might have a disruptive effect upon hepatic monoamine oxidase, with a subsequent decrease in clearance of tyramine. We have reached a similar conclusion on the possible role of tyramine in the development of the encephalopathy, based on the finding that the hepatic monoamine oxidase activity was reduced about 60% in stage V Reye's syndrome patients.

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Reye Syndrome and Salicylates: A Spurious Association

PEDIATRICS ◽

10.1542/peds.70.1.158a ◽

1982 ◽

Vol 70 (1) ◽

pp. 158-160

Author(s):

Keyword(s):

Scientific Evidence ◽

Case Control ◽

Reye Syndrome ◽

Spurious Association

The intent of this communication is to show that the potential for bias, confounding, and/or change in the reported case-control surveys of Reye syndrome (RS) was sufficiently great so as to make any and all inferences pertaining to associations or causality between aspirin and RS highly questionable—or worse—misleading. Further, five lines of recent clinical and scientific evidence question the biologic plausibility of the claimed association.

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Reye Syndrome and Aspirin Use: The Role of Prodromal Illness Severity in the Assessment of Relative Risk

PEDIATRICS ◽

10.1542/peds.69.6.822 ◽

1982 ◽

Vol 69 (6) ◽

pp. 822-825

Author(s):

John T. Wilson ◽

R. Don Brown

Keyword(s):

Relative Risk ◽

Infectious Diseases ◽

Epidemiologic Study ◽

Study Data ◽

The State ◽

Reye Syndrome ◽

Confounding Variable ◽

Large Magnitude ◽

American Academy Of Pediatrics

In response to "Aspirin and Reye Syndrome" by the Committee on Infectious Diseases of the American Academy of Pediatrics (p 810), we offer comments which are restricted to our analysis of existing epidemiologic study data, portions of which were provided to us by the Ohio, Michigan, and Arizona investigators. This commentary should not be construed as our approval or disapproval of aspirin use in children. Rather, it summarizes our specific disagreements with the interpretation of the state epidemiologic data that were the basis of the report by the Committee on Infectious Diseases. We have found that an unassessed confounding variable of large magnitude is common to the state studies.

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Reye Study Criticized

PEDIATRICS ◽

10.1542/peds.82.3.393 ◽

1988 ◽

Vol 82 (3) ◽

pp. 393-394

Author(s):

JAMES P. ORLOWSKI

Keyword(s):

United States ◽

Great Britain ◽

The United States ◽

Scientific Data ◽

West Germany ◽

Reye Syndrome ◽

Original Series ◽

The World

In Reply.— I appreciate Dr Hall's thoughtful and thorough critique of our article. I will address each of her points to show that our conclusions are just as logical and based on as much scientific data as her alternate interpretations. First, Reye syndrome should be the same disease in Australia (and anywhere else in the world) as it is in the United States. As Hall points out, our series1 is remarkably similar not only to the original series of Reye et al2 but also to her own series in Great Britain,3 studies from Asia,4 a study from Ireland,5 a recent study from Spain,6 a report from France,7 and a recent study from West Germany.8

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