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Adult Reye's syndrome
1Department of Emergency Medicine, University of Calgary, Alberta, Canada.
Annals of Emergency Medicine
|February 1, 1988
Summary
This case study highlights a rare instance of Reye's syndrome in an adult, initially misdiagnosed as a drug overdose or psychotic crisis. Prompt diagnosis via ammonia levels and liver biopsy led to successful supportive treatment and full recovery.
Area of Science:
- Internal Medicine
- Neurology
- Toxicology
Background:
- Reye's syndrome is a rare but serious condition that causes swelling in the liver and brain.
- It primarily affects children and teenagers recovering from viral infections like the flu or chickenpox.
- While typically associated with aspirin use, its etiology in adults can be complex and challenging to diagnose.
Observation:
- A 40-year-old woman presented with flu-like symptoms, vomiting, and altered mental status.
- Initial assessment revealed therapeutic levels of common medications (salicylates, trazodone, acetaminophen), complicating the diagnostic picture.
- A tentative diagnosis of psychotic crisis with possible drug overdose was considered.
Findings:
- The patient's acute encephalopathy was ultimately diagnosed as Reye's syndrome.
- Diagnostic confirmation was achieved through elevated plasma ammonia levels and liver biopsy.
- This case underscores the potential for Reye's syndrome in adults, even without a clear history of aspirin use.
Implications:
- This case expands the known clinical spectrum of Reye's syndrome, suggesting it can occur in adults under various circumstances.
- It emphasizes the importance of considering rare diagnoses in cases of unexplained encephalopathy, especially when initial presentations are atypical.
- Accurate and timely diagnosis is crucial for initiating appropriate supportive care and improving patient outcomes in Reye's syndrome.