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Acute encephalopathy in siblings. Reye syndrome vs salicylate intoxication

Insights

Two siblings developed Reye syndrome after aspirin treatment for respiratory infections. High salicylate levels indicated potential aspirin toxicity, complicating diagnosis and treatment.

Area of Science:

  • Pediatric Medicine
  • Toxicology
  • Neurology

Background:

  • Reye syndrome is a rare but serious condition affecting the brain and liver.
  • Aspirin use in children with viral illnesses has been linked to Reye syndrome.
  • Distinguishing Reye syndrome from other conditions is crucial for timely intervention.

Observation:

  • Two siblings presented with simultaneous vomiting, disorientation, ataxia, and coma.
  • Both children had preceding upper respiratory tract infection symptoms.
  • Both children were treated with high doses of aspirin.

Findings:

  • Laboratory results indicated hepatocellular dysfunction and elevated serum ammonia in one sibling.
  • Salicylate levels were significantly elevated at 50 and 44 mg/100 ml.
  • Autopsy of the deceased sibling revealed cerebral edema and fatty liver.

Implications:

  • This case highlights the diagnostic challenges in differentiating Reye syndrome from salicylate intoxication.
  • It underscores the importance of considering aspirin toxicity in children with similar symptoms.
  • Further research is needed to clarify the relationship between aspirin dosage and Reye syndrome risk.

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