Reye syndrome

Background

Clinical Features

  • Stage I
  • Stage II
  • Stage III
    • Possible coma
    • Possible cerebral edema
    • Rarely, respiratory arrest
  • Stage IV
    • Deepening coma
    • Dilated pupils with minimal response to light
    • Minimal hepatic dysfunction
  • Stage V
  • Death

Differential Diagnosis

Evaluation

  • CBC
  • Chem 10
  • ABG
  • LFTs
  • Ammonemia
  • Acetaminophen level (rule out coingestion/alternate cause of liver failure)
  • ASA level (rule out overdose)
  • Fingerstick (can be hypoglycemic)
  • UDS
  • LP
  • ECG
  • EEG (coma)

Management

ABCs

  • Consider intubation if stage II or higher
  • Ensure IV access with fluid resus
  • Monitor neuro status closely, treat signs of cerebral edema aggressively

Consultations

  • Consider NSG Consult for cerebral edema
  • Consider GI consult for liver biopsy
  • Consider metabolic disorders

Also See

References

  1. Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.
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