Reye syndrome

Acute encephalopathy associated with acute liver failure: GPT level increase, hypoglycemia, hyperammonemia. Usually starts during or just after a viral illness (respiratory, digestive, varicella) with vomiting and confusion or lethargy. Cerebral edema and microvacuolar fatty liver, no hepatocellular necrosis. Mitochondrial dysfunction. As a result of an epidemic in the 1970-1980s, an association with the administration of aspirin has been demonstrated in epidemiological studies which are considered as controversial today. In children younger than 3 years with a similar clinical presentation, a symptomatic treatment of the acute liver failure must be started while collecting blood and urine samples to diagnose an underlying metabolic disease, decompensated by the viral infection.


Anesthetic implications:

acute liver failure. Suspect an underlying metabolic disease such as an urea cycle disorder, or a fatty acid oxidation disorder, carnitine deficiency, organic aciduria, fructose intolerance.


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Updated: October 2018