Reassessing Reye Syndrome

In 1963, Reye and associates¹ described a syndrome in 21 children, characterized by acute encephalopathy, hepatic steatosis, and elevated levels of serum transaminases. Subsequent studies in the 1960s and 1970s revealed that it was a virus-related illness mainly associated with antecedent influenza B and varicella virus infections. In 1977, 454 cases of Reye syndrome were reported in the United States, and of 373 cases with follow-up, 42% died and 11% had residual neurologic damage.² In the late 1970s and early 1980s, a number of case-control studies described an association between aspirin ingestion and the development of Reye syndrome.³ The Committee of Infectious Disease of the American Academy of Pediatrics and the Centers for Disease Control and Prevention recommended that aspirin-containing products not be given to children. In 1986, a warning label was required for all aspirin-containing products sold in the United States. In the last 2 decades, reported Reye syndrome cases have fallen from 555 in 1980 to fewer than 2 per year from 1994 through 1997.³ We report a case of a child with aspirin-related Reye syndrome to emphasize the continued risk of this potentially fatal disease.