Creator: Dr. Nithin Jayan
Keywords: Reye's syndrome, Reye syndrome, LFT, liver function test, Liver biopsy, spinal tap, SGOT, SGPT, AST, ALT, LDH, PT, Aptt, Lactic dehydrogenase, Bilirubin, Transaminases, Prothrombin time, activated partial thromboplastin time, Lipase, Amylase, Serum bicarbonate, ketonuria

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

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