Essay/Term paper: Reye syndrome

Essay, term paper, research paper:  Medicine

Reye Syndrome


Reye Syndrome is an extremely rare, non-contagious disease thought to be
triggered by aspirin use. The actual origin of the disease is unknown. Reye's
Syndrome, occasionally called Reye-Jacobsen's Syndrome, is known to follow any
viral infection. Two of the most common viral infections it precedes is
influenza, "the flu", and chicken pox. A now-familiar warning on bottles of
aspirin, most notably Tylenol, is not to give Tylenol to a child who is
recovering from the chicken pox, a fever, or any other viral infection. The
link between aspirin and Reye's Syndrome and is not fully understood, but all
reported cases of Reye's Syndrome include a child who has received aspirin
before infection.

Symptoms of Reye's Syndrome may often be mistook for a recurrence of the
flu, or extreme exhaustion. These symptoms include vomiting, confusion, lack of
coordination, distorted balance, irritability, a stupor-like state, and a recent
infection from a viral illness. The symptoms often begin with vomiting and
progress to a stupor and near comatose state. This disease is often found in
young children and infants. Over sixty percent of reported Reye's Syndrome
cases occur in children under the age of sixteen, with the majority of these
cases being in children under six. Although less than five percent of Reye's
Syndrome cases occur in people over the age of sixty, the elderly are often the
most severely affected, due to old age and weakening immune systems. Infants,
while hindered by their young age, can often fight the infections of Reye
Syndrome better, for reasons doctors do not yet fully understand. The severity
of Reye's Syndrome is classified on a scale of 1-5, with one and two being the
onset of symptoms and four and five being the most severe, with the patient
being comatose. With the most severe of Reye's Syndrome cases, internal fluid
builds up in the brain and there is irreversible brain damage or even death.
While the disease is not often fatal, it is essential to treat the disease early.
Reye's Syndrome is not contagious, but the diseases that can lead to, such as
the flu, and chicken pox, are highly communicable.

The first case of Reye's Syndrome was diagnosed in 1963. Looking back
into medical journals, there were many "mystery illnesses" that had the same
symptoms as Reye's Syndrome, but no cases were positively diagnosed as being
Reye Syndrome until this date. The definitive tests for this disease are a
liver biopsy and blood analysis. The liver biopsy can help determine the
presence of fat and lipid formation in the liver. Upon surgical examination,
the liver is slightly enlarged, firm, and bright yellow. This includes some of
the symptoms of jaundice, but without the yellowing of the skin and pupils of
the eye. There is often bile build-up within the liver, and fat formation on the
liver walls is always present. The blood test can detect the presence of
ammonia and acid within the blood. The failing liver will produce these
chemicals. There is also a dramatic decrease in blood sugar levels, which can
mistakenly be diagnosed as hypoglycemia. Therefore, a liver biopsy is essential
in making a complete and correct diagnosis of Reye's Syndrome.

The treatment for Reye's Syndrome had made great advancements in the
last decade. Through the 1960's and the 1970's, the fatality rate for victims
of Reye's Syndrome was over forty percent. In the 1990's, this fatality rate
has decreased to less than ten percent. Part of this decrease is due to a
greater elevation of public awareness. Doctors are able to give more complete
information to their patients. Parents who have children recovering from the
flu and chicken pox are warned never to give aspirin for fever and pain.
Another reason for the decrease in fatalities is due to increasingly better
understanding of the disease. Before the first diagnosis in 1963, patients who
could have had Reye's Syndrome were treated with medication for intestinal and
stomach flu, or given anti-nausea drugs and aspirin(obviously, a big no-no) and
sent home with instructions to call the doctor if it got any worse. Many of
these "treatments" ended in death for the patient. Treatment of the patient now
includes cortosteroids to treat brain swelling. This has greatly helped reduce
the occurrence of moderate to severe brain damage in patients with Reye Syndrome.
All treatment is given intravenously, which can help to stabilize the blood
chemistry. Stabilizing this is extremely important to the survival of the
patient because of the high levels of ammonia and acid within the body that
circulate through the blood. The treatment given to people with Reye's Syndrome
is more passive than active treatment. This includes monitoring the heart rate,
giving intravenous fluid to prevent dehydration, and keeping fevers down.

Depending upon the severity of the illness, the recovery periods will
vary from case to case. The younger a child, the longer the recovery period,
which can last anywhere from two weeks to three months. When a patient has
contracted Reye's syndrome after having the chicken pox or influenza, as opposed
to a common cold or other viral infection, the recovery period is substantially
lengthened.

New and groundbreaking research for the link between aspirin and Reye's
Syndrome is now underway in places such as Johns Hopkins University, the Mayo
Clinic, and The California Center for Disease Control, or CCDC. The CCDC has
come up with a theory that is becoming more and more widely accepted. A
possible link, they claim, is the chemical effects of aspirin on the brain.
While reducing fever and pain, aspirin may, they hypothesize, cause the body to
release endorphins that can trigger the onset of Reye's Syndrome. Another
probable theory has been introduced by scientists at the Mayo Clinic. Aspirin,
they theorize, lowers the body's immunity to certain micro-organisms that may
cause the beginning of Reye Syndrome.

While Reye's Syndrome used to be a misunderstood and often fatal disease,
public understanding has greatly increased. The training of doctors and medical
assistants has greatly increased, and their knowledge of the disease has greatly
increased. Along with this increased public awareness is the breakthrough
research mentioned above. Over eighty million dollars was allotted to study
Reye's Syndrome in 1993, and that amount has increased greatly since then. As
the twentieth century looks towards new developments in medicine and disease
control, Reye's Syndrome will hopefully become nothing more than an obsolete
disease of the past.