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Reye Syndrome

Reye Syndrome is a topic covered in the 5-Minute Emergency Consult.

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  • Reversible clinicopathologic syndrome of unknown etiology
  • Primary mitochondrial injury
  • Decreased enzyme activity:
    • Krebs cycle
    • Gluconeogenesis
    • Urea biosynthesis
  • Fatty infiltration:
    • Liver:
      • Hyperammonemia due to decreased conversion from ammonia to urea
      • Hepatorenal syndrome may be the end result.
      • Rapid recovery of liver function in survivors
    • Brain:
      • Encephalopathy of unclear etiology
      • Cytotoxic edema
      • Deteriorating level of consciousness reflects increasing intracranial pressure (ICP).
      • Herniation is the most common cause of death.
      • Normal recovery of neurologic function in survivors
    • Skeletal and myocardial muscle
    • Fatty infiltration and distorted mitochondria
  • <10% of cases occur before the age of 1 yr:
    • Average age is 7 yr
    • Peak age is 4–11 yr
    • Extremely rare in age >18 yr.
  • Regional differences:
    • Highest incidence in the Midwestern states
    • Lower incidence in the states of the Southeast and far West
  • More common in whites than in blacks
  • Peak incidence in winter and early spring
  • Reye-like syndrome:
    • Describes conditions resulting in defects in urea and fatty acid metabolism, toxicologic injury, and impaired gluconeogenesis


  • Not known with certainty
  • Multifactorial causes have been epidemiologically implicated:
    • Antecedent viral syndrome
    • Influenza A or B
    • Varicella
    • Diarrhea illness
    • Genetic predisposition
    • Exposure to salicylates
    • Other undefined factors

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Rosen, Peter, et al., editors. "Reye Syndrome." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307118/all/Reye_Syndrome.
Reye Syndrome. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307118/all/Reye_Syndrome. Accessed April 23, 2019.
Reye Syndrome. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307118/all/Reye_Syndrome
Reye Syndrome [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307118/all/Reye_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Reye Syndrome ID - 307118 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307118/all/Reye_Syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -