Diagnosis of Reye�s Syndrome

Diagnosis of Reye's Syndrome

Diagnosis of Reye's syndrome follows the elicitation of a proper medical history and detailed physical examination. A number of blood tests (mostly to assess the function of liver) are ordered.

• Ammonia level as high as 1.5 times normal 24-48 hours after the onset of mental status changes is the commonest laboratory irregularity in Reye's syndrome.
• Transaminases levels: The level of liver enzymes ALT (SGPT) and AST(SGOT) increase
• Bilirubin levels
• Lactic dehydrogenase (LDH) level: may be high or low
• Prothrombin time (PT) and activated partial thromboplastin time (aPTT): are prolonged

• Lipase and amylase: are elevated
• Serum bicarbonate: may be increased due to vomiting
• BUN and creatinine: elevated
• Glucose: level may be low (hypoglycaemia) especially in children younger than 1 year
• Anion gap and venous blood gas
• Urine specific gravity (increased) and ketones (ketonuria)

Liver biopsy (removal of a sample of liver tissue) may be done

Imaging modalities: Head CT or Head MRI; Electroencephalogram (EEG)

Spinal tap for spinal fluid analysis may be done

It is also important to rule out inborn errors of metabolism in children

References:

1. Nelson Textbook of Pediatrics, 18^th ed.
2. Cecil Medicine, 23^rd Ed.
3. Harrison's PRINCIPLES OF INTERNAL MEDICINE, 17^TH Edition