REYE'S SYNDROME

acute neurologic illness that develops in children following a minor episode of influenza, chicken pox, or other viral infections and which may, in its most serious form, result in fatty degeneration of the liver and potentially fatal swelling of the brain. It was first reported by the Australian pathologist R.D.K. Reye in 1963, after 12 years of research. Whether it is a new disease of the second half of the 20th century or an old disease previously misdiagnosed is uncertain. The disease affects people under 18 years of age, usually very young children. The affected child appears to be recovering from the viral illness when such symptoms as nausea, vomiting, lethargy, and confusion begin. Within a few hours or days the child exhibits drowsiness, disorientation, seizures, respiratory arrest, and coma. The precise cause of the syndrome is unknown but is thought to be related to viral damage to the cerebral mitochondria (the subcellular structures responsible for energy metabolism). Reye's syndrome can occur following aflatoxin or warfarin poisoning and has also been associated with the use of aspirin or other salicylates during a viral illness. A decline in the incidence of the syndrome during the 1980s was attributed to the reduced use of these drugs in the treatment of viral infections in children. Although there is no specific cure, careful monitoring of the patient's vital functions and prompt correction of any imbalancesemploying antibiotics, insulin, corticosteroids, glucose, diuretics, blood serum, and other aidscan help stay the progress of the disease. More than 70 percent of patients now survive. Some recover completely, whereas others suffer some degree of brain damage.