Reye syndrome: Difference between revisions
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*Effects to many organs, especially the brain and liver | *Effects to many organs, especially the brain and liver | ||
*Associated with aspirin taken for viral illness | *Associated with aspirin taken for viral illness | ||
*Classic Early Symptoms: *Rash | *Classic Early Symptoms: | ||
**Rash | |||
**Vomiting | |||
**Liver damage | |||
*Jaundice is not usually present<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref> | *Jaundice is not usually present<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref> | ||
Revision as of 15:56, 18 May 2016
Background
- Potentially fatal syndrome
- Effects to many organs, especially the brain and liver
- Associated with aspirin taken for viral illness
- Classic Early Symptoms:
- Rash
- Vomiting
- Liver damage
- Jaundice is not usually present[1]
Clinical Presentation
- Five Stages[2]
- Stage I
- Rash on palms of hands and feet
- Persistent, heavy vomiting
- AMS, Confusion, Generalized lethargy
- High fever
- Stage II
- Stupor
- Hyperventilation
- Fatty liver (found by biopsy)
- Stage III
- Possible coma
- Possible cerebral edema
- Rarely, respiratory arrest
- Stage IV
- Deepening coma
- Dilated pupils with minimal response to light
- Minimal but still present hepatic dysfunction
- Stage V
- Deep coma
- Seizures
- Multiple organ failure[7]
- Flaccidity
- Hyperammonemia (above 300 mg/dL of blood)
- Death
- Stage I
DDx
- Shaken baby syndrome
- Head trauma
- Viral encephalitis
- Meningitis
- Drug overdose or poisoning
- Various inborn metabolic disorders
Management
- ABCs
- Consider Intubation with Stage II
- IV access with fluid resus
- Fingerstick
- hypoglycemic - dextrose 25% bolus of 1-2 mL/kg
- CBC
- Chem 10
- ABG
- EKG
- Liver Panel
- Ammonemia
- aggressive cerebral edema monitoring and treatment
- LP
- Urine Tox
- Acetaminophen Level
- ASA Level
- EEG (coma)
- Consider Central Line
- Consider NSG Consult for Cerebral Edema
- Consider GI consult for liver biopsy
- Consider Metabolic Disorders
Also See
Sources
- Uptodate
- http://emedicine.medscape.com/article/803683-overview -- last accessed 1/4/15
- ↑ Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.
- ↑ http://emedicine.medscape.com/article/803683-overview