Treatment of Reye's syndrome at Sumber Waras Hospital

Since 1974 we have seen 320 cases of Reye's syndrome in our department. There were 163 boys and 157 girls of a mean age of 20 months. While the number of Reye's syndrome patients admitted increased from 1979 to 1982, it has declined since 1984. Two different approaches to management were used. Prior to 1976 only simple supportive measures were given: Intravenous 10% dextrose solution and electrolytes (Darrow-glucose solution) in equal amounts at a rate of 50-100 ml/kg/day with or without dexamethasone (0.5 mg/kg/day). From 1976, in addition, measures were taken to lower the intracranial pressure by infusing mannitol 1-2 gm and glycerol 1 g/kg given at a frequency related to the severity of the illness, i.e., for grade II, the above combination was given 8 hourly, for grade III 6 hourly, and for grades IV and V 4 hourly, while for grade I only fluid and electrolytes were given. In all cases, clinical progress was closely followed. Intravenous dexamethasone was also given at a dose of 0.5 mg/kg/day. The fatality rate was 50 to 60% prior to 1976 and has fallen to around 20% at present. In contrast to reports from Western countries, we observed more convulsions, respiratory infections and gastrointestinal disorders but less vomiting and no chicken-pox.