Skip to main content
Log in

Reye syndrome or side-effects of anti-emetics?

  • Medical Controversies
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

By analysing two patients initially diagnosed as Reye syndrome evidence is given that in some patients considered as having Reye syndrome, the syndrome is an escalation of symptoms due to viral disease and to unrecognized drug-induced encephalopathy, mainly by anti-emetics. A detailed drug history, considering all medication — not exclusively aspirin — taken during the full course of the illness is essential to differentiate between Reye syndrome and drug-induced symptoms. In addition, a critical analysis is presented of the four main case-control surveys that have lead to the proposal that salicylates are primary causative agents of Reye syndrome. In these surveys, medications given during the prodromal illness were adequately recorded, but other drugs given after the onset of vomiting have been overlooked or deliberately excluded. New epidemiological studies are needed, recording all drugs given to the patients throughout the full course of their illness until the moment of admission, in order to elucidate the mystery of Reye syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ayd FJ (1961) A survey of drug-induced extrapyramidal reactions. JAMA 175: 1054–1060

    PubMed  Google Scholar 

  2. Bellman MH, Hall SM (1983) Aetiology of Reye's syndrome. Arch Dis Child 58: 670–672

    PubMed  Google Scholar 

  3. Bonnel HJ, Beckwith JB (1986) Fatty liver in sudden childhood death. Am J Dis Child 140: 30–33

    PubMed  Google Scholar 

  4. Casteels-Van Daele M (1970) Paroxysmal torticollis in infancy. Am J Dis Child 120: 88

    PubMed  Google Scholar 

  5. Casteels-Van Daele M, Jaeken J, Van Der Schueren P, Zimmerman A, Van Den Bon P (1970) Dystonic reactions in children caused by Metoclopramide. Arch Dis Child 45: 130–133

    PubMed  Google Scholar 

  6. Casteels-Van Daele M, Dobosz-Cyklis R, Van De Casseye W, Verbeeck P, Wijndaele L (1984) Refusal of further cancer chemotherapy due to antiemetic drug. Lancet I: 57

    Article  Google Scholar 

  7. Clark JH, Fitzgerald JF (1981) Doubts relationship of salicylate and Reye's syndrome. Pediatrics 68: 466–467

    PubMed  Google Scholar 

  8. Cottom DG, Newman CG (1966) Dystonic reactions to phenothiazine derivatives. Arch Dis Child 41: 551–553

    PubMed  Google Scholar 

  9. Daniels SR, Greenberg RS, Ibrahim MA (1983) Scientific uncertainties in the studies of Reye's syndrome. JAMA 249: 1311–1316

    Article  PubMed  Google Scholar 

  10. Delay J, Deniker P, Thuiller J (1957) Similarity of the neurological complications of prochlorperazine with various postencephalitic disorders. Ann Med Psychol 115: 506–510

    Google Scholar 

  11. Editorial Reye's Syndrome (1982) Epidemiological considerations. Lancet II: 941–943

  12. Editorial. Reye's Syndrome and Aspirin (1987) Epidemiological associations and inborn errors of metabolism. Lancet II: 429–431

  13. Fulginiti VA, Brunell PA, Cherry JF, Ector WL, Gershon AA, Gotoff SP, Hughes WT, Mortimer EA, Peter G (1982) Committee on infectious diseases. Special report: aspirin and Reye syndrome. Pediatrics 69: 810–812

    PubMed  Google Scholar 

  14. Gall DG, Barker G, Cutz E (1981) Doubts relationship of salicylate and Reye's syndrome. Pediatrics 68: 467–468

    Google Scholar 

  15. Glick T, Likosky W, Levitt L, Mellin H, Reynolds D (1970) Reye's syndrome: an epidemiologic approach. Pediatrics 46: 371–377

    Google Scholar 

  16. Gupta JM, Lovejoy FH (1967) Acute phenothiazine toxicity in childhood: a five-year survey. Pediatrics 39:771–774

    PubMed  Google Scholar 

  17. Hall SM (1986) Reye's syndrome and aspirin: a review. J R Soc Med 79:596–598

    PubMed  Google Scholar 

  18. Halpin TJ, Holtzhauer FJ, Campbell RJ, Hall LJ, Correa-Villaseñor A, Lanese R, Rice J, Hurwitz ES (1982) Reye's syndrome and medication use. JAMA 248:687–691

    Article  PubMed  Google Scholar 

  19. Hollister LE (1957) Complications from the use of tranquilizing drugs. New Eng J Med 257:170–177

    PubMed  Google Scholar 

  20. Hurwitz ES, Nelson DB, Davis C, Morens D, Schonberger LB (1982) National surveillance for Reye syndrome: a five-year review. Pediatrics 70:895–900

    PubMed  Google Scholar 

  21. Hurwitz ES, Barrett MJ, Bregman D, Gunn WJ, Pinsky P, Schönberger LB, Drage JS, Kaslow RA, Burlington DB, Quinnan GV, Lamontagne JR, Farweather WR, Dayton D, Dowdle WR (1987) Public health service study of Reye's syndrome and medications. Report of the main study. JAMA 257:1905–1911

    Article  PubMed  Google Scholar 

  22. Jabbour JT, Sheffield JA, Montalvo JM (1958) Severe neurological manifestations in four children receiving compazine (Prochlorperazine). J Pediatr 53:153–159

    PubMed  Google Scholar 

  23. Linnemann CC, Shea L, Kauffman C, Schiff GM, Partin JC, Schubert WK (1974) Association of Reye's syndrome with viral infection. Lancet II:179–182

    Article  Google Scholar 

  24. Linnemann CC, Shea L, Partin JC, Schubert WK, Schiff GM (1975) Reye's syndrome: epidemiologic and viral studies, 1963–1974. Am J Epidemiol 101:517–526

    PubMed  Google Scholar 

  25. Mahoudeau D, Dubrisay J, Corcket F (1957) Transitory pseudotetanic syndrome following ingestion of phenothiazine derivatives. Bull Soc méd Hôp Paris 73:123–125

    Google Scholar 

  26. National Institutes of Health (1981) Diagnosis and treatment of Reye's syndrome. JAMA 246:2441–2444

    Google Scholar 

  27. Olson L, Bourgeois C, Cotton R, Harikul S, Grossman R, Smith T (1971) Encephalopathy and fatty degeneration of the viscera in northeastern Thailand. Clinical syndrome and epidemiology. Pediatrics 47:707–716

    PubMed  Google Scholar 

  28. Orlowski JP, Gillis J, Kilham HA (1987) A catch in the Reye. Pediatrics 80:638–642

    PubMed  Google Scholar 

  29. Reye RD, Morgan G, Baral J (1963) Encephalopathy and fatty degeneration of the viscera. A disease entity in childhood. Lancet II:749–752

    Article  Google Scholar 

  30. Reynolds D, Riley H, LaFont D, Vorse H, Clarke Stout L, LeRoy Carpenter R (1972) An outbreak of Reye's syndrome associated with influenza B. J Pediatr 80:429–432

    PubMed  Google Scholar 

  31. RS Working Group Aspirin in Foundation of America, Washington (1982) Reye syndrome and salicylates: a spurious association. Pediatrics 70:158–160

    Google Scholar 

  32. Starko KM, Ray CG, Dominguez LB, Stromberg WL, Woodall DF (1980) Reye's syndrome and salicylate use. Pediatrics 66:859–864

    PubMed  Google Scholar 

  33. Thaler M, Hoogenraad N, Boswell M (1974) Reye's syndrome due to a novel protein-tolerant variant of ornithine-transcarbamylase deficiency. Lancet II:438–440

    Article  Google Scholar 

  34. Waldmann RJ, Hall WN, McGee H, Van Amburg G (1982) Aspirin as a risk factor in Reye's syndrome. JAMA 247:3089–3094

    Article  PubMed  Google Scholar 

  35. Wilson JT, Brown RD (1982) Reye syndrome and aspirin use: the role of prodromal illness severity in the assessment of relative risk. Pediatrics 69:822–825

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daele, M.CV. Reye syndrome or side-effects of anti-emetics?. Eur J Pediatr 150, 456–459 (1991). https://doi.org/10.1007/BF01958420

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01958420

Key words

Navigation