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aspirin and Reye syndrome

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1. Reye's syndrome

Reye's syndrome Reye's syndrome - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Reye's syndrome Last reviewed: February 2019 Last updated: March 2018 Summary An acute encephalopathy with hepatic dysfunction stemming from mitochondrial damage. Aetiology remains unknown, but viral infections, exogenous toxins, drugs, and inborn errors of metabolism have been implicated. Aspirin is classically associated but data (...) . Prognosis is generally good, and liver function returns to normal. However, encephalopathy can result in permanent neurological sequelae. Definition Reye's syndrome is an illness that meets all of the following criteria: Centers for Disease Control and Prevention. Reye syndrome: 1990 clinical case definition. 1990 [internet publication]. http://wwwn.cdc.gov/nndss/conditions/reye-syndrome/case-definition/1990/ an acute, non-inflammatory encephalopathy with either sterile CSF containing <9 WBC/mL

2018 BMJ Best Practice

2. Reye's Syndrome

Delirium Convulsions Loss of consciousness If these symptoms occur soon after a viral illness, seek medical attention immediately. Reye syndrome can lead to a coma and brain death, so quick diagnosis and treatment are critical. Treatment focuses on preventing brain damage. There is no cure. The cause of Reye syndrome is unknown. Studies have shown that taking aspirin increases the risk of getting it. Because of that, health care professionals now recommend other pain relievers for young patients. NIH (...) , it can also occur in the absence of aspirin use. Definition (NCI_NCI-GLOSS) A rare disease that damages the brain and liver and causes death if not treated. It occurs most often in children younger than 15 years who have had a fever-causing virus, such as chickenpox or flu. Taking aspirin during a viral illness may increase the risk of Reye syndrome. Definition (MSH) A form of encephalopathy with fatty infiltration of the LIVER, characterized by brain EDEMA and VOMITING that may rapidly progress

2018 FP Notebook

3. Low-Dose Aspirin Use During Pregnancy

bronchospasm (27). Relative con- traindications to low-dose aspirin include a history of gastrointestinal bleeding, active peptic ulcer disease, other sources of gastrointestinal or genitourinary bleed- ing, and severe hepatic dysfunction. Reye syndrome has been reported rarely (less than 1%) in children younger than 18 years who are given aspirin while recovering from viral illnesses, particularly influenza and chicken- pox. The decision to continue low-dose aspirin in the presence of obstetric bleeding (...) Recommend low-dose aspirin if the patient has one or more of these high-risk factors Multifetal gestation Chronic hypertension Type 1 or 2 diabetes Renal disease Autoimmune disease (systemic lupus erythematosus, antiphospholipid syndrome) Moderate z Nulliparity Consider low-dose aspirin if the patient has more than one of these moderate-risk factors § Obesity (body mass index greater than 30) Family history of preeclampsia (mother or sister) Sociodemographic characteristics (African American

2018 American College of Obstetricians and Gynecologists

4. Low-Dose Aspirin Use During Pregnancy

bronchospasm (27). Relative con- traindications to low-dose aspirin include a history of gastrointestinal bleeding, active peptic ulcer disease, other sources of gastrointestinal or genitourinary bleed- ing, and severe hepatic dysfunction. Reye syndrome has been reported rarely (less than 1%) in children younger than 18 years who are given aspirin while recovering from viral illnesses, particularly influenza and chicken- pox. The decision to continue low-dose aspirin in the presence of obstetric bleeding (...) Recommend low-dose aspirin if the patient has one or more of these high-risk factors Multifetal gestation Chronic hypertension Type 1 or 2 diabetes Renal disease Autoimmune disease (systemic lupus erythematosus, antiphospholipid syndrome) Moderate z Nulliparity Consider low-dose aspirin if the patient has more than one of these moderate-risk factors § Obesity (body mass index greater than 30) Family history of preeclampsia (mother or sister) Sociodemographic characteristics (African American

2018 American College of Obstetricians and Gynecologists

5. Pediatrics, Reye Syndrome (Follow-up)

of therapy (eg, Kawasaki disease). Of approximately 200,000 children in Japan who were treated with aspirin for Kawasaki disease, only 1 was reported to have developed Reye syndrome. In children who require long-term salicylate therapy, use of these agents should be discontinued immediately at the first signs or symptoms of Reye syndrome. It is critical to be alert for and recognize early symptoms of Reye syndrome. It is also important to be mindful of the possibility that an IEM may be the actual cause (...) of the symptoms and, if this is the case, to be prepared to treat the IEM. Appropriate management of IEMs dramatically decreases morbidity and mortality. (See .) Influenza vaccine is recommended by the Centers for Disease Control and Prevention (CDC) for everyone older than 6 months. Previous References Schrör K. Aspirin and Reye syndrome: a review of the evidence. Paediatr Drugs . 2007. 9(3):195-204. . Glasgow JF, Middleton B, Moore R, Gray A, Hill J. The mechanism of inhibition of beta-oxidation by aspirin

2014 eMedicine Emergency Medicine

6. Pediatrics, Reye Syndrome (Treatment)

of therapy (eg, Kawasaki disease). Of approximately 200,000 children in Japan who were treated with aspirin for Kawasaki disease, only 1 was reported to have developed Reye syndrome. In children who require long-term salicylate therapy, use of these agents should be discontinued immediately at the first signs or symptoms of Reye syndrome. It is critical to be alert for and recognize early symptoms of Reye syndrome. It is also important to be mindful of the possibility that an IEM may be the actual cause (...) of the symptoms and, if this is the case, to be prepared to treat the IEM. Appropriate management of IEMs dramatically decreases morbidity and mortality. (See .) Influenza vaccine is recommended by the Centers for Disease Control and Prevention (CDC) for everyone older than 6 months. Previous References Schrör K. Aspirin and Reye syndrome: a review of the evidence. Paediatr Drugs . 2007. 9(3):195-204. . Glasgow JF, Middleton B, Moore R, Gray A, Hill J. The mechanism of inhibition of beta-oxidation by aspirin

2014 eMedicine Emergency Medicine

7. Pediatrics, Reye Syndrome (Diagnosis)

States, Reye syndrome became a reportable disease in 1973. Peak incidence was reported in 1979-80. [ , , ] Reye syndrome typically occurs after a viral illness, particularly an upper respiratory tract infection, , , or , and is associated with the use of aspirin during the illness. A dramatic decrease in the use of aspirin among children, in combination with the identification of medication reactions, toxins, and (IEMs) that present with Reye syndrome–like manifestations, have made the diagnosis (...) . Salicylates The association of Reye syndrome with salicylates, particularly aspirin, was demonstrated in several epidemiologic studies around the world. Less than 0.1% of children who took aspirin developed Reye syndrome, but more than 80% of patients diagnosed with Reye syndrome had taken aspirin in the past 3 weeks. A causal relation between Reye syndrome and salicylates has not been definitively established and has been questioned on the basis of biases and limitations in the studies

2014 eMedicine Emergency Medicine

8. Pediatrics, Reye Syndrome (Overview)

States, Reye syndrome became a reportable disease in 1973. Peak incidence was reported in 1979-80. [ , , ] Reye syndrome typically occurs after a viral illness, particularly an upper respiratory tract infection, , , or , and is associated with the use of aspirin during the illness. A dramatic decrease in the use of aspirin among children, in combination with the identification of medication reactions, toxins, and (IEMs) that present with Reye syndrome–like manifestations, have made the diagnosis (...) . Salicylates The association of Reye syndrome with salicylates, particularly aspirin, was demonstrated in several epidemiologic studies around the world. Less than 0.1% of children who took aspirin developed Reye syndrome, but more than 80% of patients diagnosed with Reye syndrome had taken aspirin in the past 3 weeks. A causal relation between Reye syndrome and salicylates has not been definitively established and has been questioned on the basis of biases and limitations in the studies

2014 eMedicine Emergency Medicine

9. Which Kind of Baby Aspirin Should I Take To Prevent Heart Attack? Chewable Versus Enteric Coated Versus Regular

she was at the local Walgreen’s. Aspirin or acetyl salicylic acid (ASA) comes in either a 325 mg dose or in a low dose which can be between 75 to 100 mg and is often called “baby” aspirin. However, since a link between aspirin use and a potentially lethal disease called Reye’s syndrome was identified in the 1980s, no authorities recommend aspirin in children or babies, and the low dose ASA (LDASA) is primarily marketed and used for prevention of cardiovascular disease. Although Bayer and Dr. Oz (...) Which Kind of Baby Aspirin Should I Take To Prevent Heart Attack? Chewable Versus Enteric Coated Versus Regular Which Kind of Baby Aspirin Should I Take To Prevent Heart Attack? Chewable Versus Enteric Coated Versus Regular | The Skeptical Cardiologist Primary Menu Search for: , , , Which Kind of Baby Aspirin Should I Take To Prevent Heart Attack? Chewable Versus Enteric Coated Versus Regular The skeptical cardiologist recently asked his Eternal Fiancée to grab a bottle of baby aspirin while

2018 The Skeptical Cardiologist

10. Aspirin as an add-on Treatment of Refractory Epilepsy in Tuberous Sclerosis Complex

: because when children and adolescents suffering from influenza or chickenpox, using aspirin may cause a rare life-threatening Reye syndrome (characterized with persistent vomiting), should temporary withdrawal, medication needs to consult a physician before using again. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer (...) System Diseases Nervous System Diseases Cognition Disorders Neurocognitive Disorders Mental Disorders Hamartoma Neoplasms Neoplasms, Multiple Primary Neoplastic Syndromes, Hereditary Malformations of Cortical Development, Group I Malformations of Cortical Development Nervous System Malformations Neurocutaneous Syndromes Heredodegenerative Disorders, Nervous System Neurodegenerative Diseases Congenital Abnormalities Genetic Diseases, Inborn Aspirin Anti-Inflammatory Agents, Non-Steroidal Analgesics

2017 Clinical Trials

11. Linking Drugs to Obscure Illnesses: Lessons from Pure Red Cell Aplasia, Nephrogenic Systemic Fibrosis, and Reye's Syndrome. A Report From the Southern Network on Adverse Reactions (SONAR). (PubMed)

Linking Drugs to Obscure Illnesses: Lessons from Pure Red Cell Aplasia, Nephrogenic Systemic Fibrosis, and Reye's Syndrome. A Report From the Southern Network on Adverse Reactions (SONAR). Identification of serious adverse drug reactions (sADRS) associated with commonly used drugs can elude detection for years. Reye's syndrome (RS), nephrogenic systemic fibrosis (NSF), and pure red cell aplasia (PRCA) among chronic kidney disease (CKD) patients were recognized in 1951, 2000, and 1998 (...) , respectively. Reports associating these syndromes with aspirin, gadodiamide, and epoetin, were published 29, 6, and 4 years later, respectively. We obtained primary information from clinicians who identified causes of these sADRs and reviewed factors contributing to delayed identification of these toxicities. Overall, 3,500 aspirin-associated RS cases in the United States, 1,605 gadolinium-associated NSF cases, and 181 epoetin-associated PRCA cases were reported. Delays in FDA regulation of over

Full Text available with Trip Pro

2012 Journal of General Internal Medicine

12. Reye's Syndrome

Delirium Convulsions Loss of consciousness If these symptoms occur soon after a viral illness, seek medical attention immediately. Reye syndrome can lead to a coma and brain death, so quick diagnosis and treatment are critical. Treatment focuses on preventing brain damage. There is no cure. The cause of Reye syndrome is unknown. Studies have shown that taking aspirin increases the risk of getting it. Because of that, health care professionals now recommend other pain relievers for young patients. NIH (...) , it can also occur in the absence of aspirin use. Definition (NCI_NCI-GLOSS) A rare disease that damages the brain and liver and causes death if not treated. It occurs most often in children younger than 15 years who have had a fever-causing virus, such as chickenpox or flu. Taking aspirin during a viral illness may increase the risk of Reye syndrome. Definition (MSH) A form of encephalopathy with fatty infiltration of the LIVER, characterized by brain EDEMA and VOMITING that may rapidly progress

2015 FP Notebook

13. Aspirin Increases Mitochondrial Fatty Acid Oxidation (PubMed)

into mitochondria. The drive on mitochondrial fatty acid oxidation may be a compensatory response to altered mitochondrial morphology and inhibited electron transport chain function, both of which were observed after 24 h incubation of cells with aspirin. These studies provide insight into the pathophysiology of Reye Syndrome, which is known to be triggered by aspirin ingestion in patients with fatty acid oxidation disorders.Copyright © 2016 Elsevier Inc. All rights reserved. (...) Aspirin Increases Mitochondrial Fatty Acid Oxidation The metabolic effects of salicylates are poorly understood. This study investigated the effects of aspirin on fatty acid oxidation. Aspirin increased mitochondrial long-chain fatty acid oxidation, but inhibited peroxisomal fatty acid oxidation, in two different cell lines. Aspirin increased mitochondrial protein acetylation and was found to be a stronger acetylating agent in vitro than acetyl-CoA. However, aspirin-induced acetylation did

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2016 Biochemical and biophysical research communications

14. Reye Syndrome

infections, particularly when salicylates are used. Diagnosis is clinical. Treatment is supportive. The cause of Reye syndrome is unknown, but many cases seem to follow infection with influenza A or B or varicella. Using salicylates (generally aspirin ) during such illness increases the risk by as much as 35-fold. This finding has led to a marked decrease in salicylate use in the US since the mid-1980s (except when specifically indicated, such as in and ) and a corresponding decrease in the incidence (...) is common to maintain euglycemia. Coagulopathy may require fresh frozen plasma or vitamin K. Other treatments (eg, exchange transfusion, hemodialysis, barbiturate-induced deep coma) have not been proved effective but are sometimes used. Key Points Reye syndrome of acute encephalopathy and hepatic dysfunction, typically occurring after viral infection (particularly with salicylate use), has become rare since routine use of aspirin in children has been reduced. Diagnosis is by exclusion of similarly

2013 Merck Manual (19th Edition)

15. Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome

dialysis (n=310), and chronic dialysis (n=47). In-hospital mortality Adjusted RR reduction for the combination of in-hospital aspirin and ß-blocker was 80%, 74.9%, 69%, 64.3%, and 77.9% across the quartiles of corrected CrCl, respectively. ACE indicates angiotensin-converting enzyme; ACS, acute coronary syndrome; AMI, acute myocardial infarction; CAPRICORN, Carvedilol Postinfarct Survival Control in Left Ventricular Dysfunction; CCP, Cooperative Cardiovascular Project; CI, confidence interval; CKD (...) focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2012;126:875–910. doi: 10.1161/CIR.0b013e318256f1e0. 43. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK; Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494–502. doi

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2015 American Heart Association

16. Thoughts on a 23-year-old athlete dying from the Lemierre Syndrome

must do better. Share this: Like this: Like Loading... Comments (2) said on 04-11-2018 In another era we had Reyes Syndrome where children with a trivial illness would get aspirin for their fever, develop hepatic encephalopathy and die at the pedicatric hospital with supportive care. At the time tylenol was a relatively new and costly alternative for a fever and most parents opted for aspirin. Today we physicians get a lot of public flack for antibiotic use for things that usually are self-limited (...) Thoughts on a 23-year-old athlete dying from the Lemierre Syndrome db's Medical Rants » Blog Archive » Thoughts on a 23-year-old athlete dying from the Lemierre Syndrome Internal medicine, American health care, and especially medical education 2 Posted by rcentor | Posted on 03-11-2018 Category : Every time I read such a story my heart breaks, a small piece each time. More physicians have become aware of the Lemierre syndrome. We must also educate patients and families that sore throats

2018 db's Medical Rants blog

17. Aspirin in Kawasaki disease

and is given for only a short period. Only low dose in the range of three to five milligrams per kilogram body weight is needed for antiplatelet effect and is given for a longer period. Aspirin – ibuprofen interaction Ibuprofen can interfere with the antiplatelet effect of low dose aspirin and should be avoided in children needing low dose aspirin for its antiplatelet effect as with coronary aneurysms in Kawasaki disease. Reye syndrome with aspirin Reye syndrome is a potentially fatal situation (...) with involvement of brain and liver which can occur in children on aspirin when they develop influenza or varicella. It has been reported in children taking high dose aspirin for a prolonged period in Kawasaki disease. But it is not clear whether low dose aspirin given for antiplatelet effect in case of coronary aneurysms also predisposes to Reye syndrome. Similar concerns over Varicella vaccination has also been raised as manufacturers recommend avoiding aspirin for 6 weeks after vaccination. Substitution

2015 Cardiophile MD blog

18. Aspirin-Induced Acute Liver Injury (PubMed)

Aspirin-Induced Acute Liver Injury Aspirin is thought to be a relatively safe drug in adults. The association of aspirin and Reye syndrome in children is well documented. We report a 41-year-old female with pericarditis who was treated with high-dose aspirin and developed subsequent acute liver injury. After discontinuation of aspirin, liver enzyme elevation and right upper quadrant pain both resolved. We conclude that high-dose aspirin should be considered as a potentially hepatotoxic agent.

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2014 ACG case reports journal

19. Reye's syndrome

may include a , , and prolonged . Often the . Prevention is typically by avoiding the use of aspirin in children. When aspirin was withdrawn for use in children a decrease of more than 90% in rates of Reye syndrome was seen. Early diagnosis improves outcomes. Treatment is . may be used to help with the . The first detailed description of Reye syndrome was in 1963 by , an Australian pathologist. Children are most commonly affected. It affects fewer than one in a million children a year. The general (...) recommendation to use aspirin in children was withdrawn because of Reye syndrome, with use of aspirin only recommended in . Contents Signs and symptoms [ ] Reye syndrome progresses through five stages: Stage I Rash on palms of hands and feet Persistent, heavy that is not relieved by not eating Generalized No usually present Headaches Stage II (found on ) Stage III Continuation of Stage I and II symptoms Possible Possible Rarely, Stage IV Deepening coma Dilated pupils with minimal response to light Minimal

2012 Wikipedia

20. Sturge-Weber Syndrome (Treatment)

and migraine headaches self-reported treatment patterns through a questionnaire. [ ] Previous Next: Strokelike Events Aspirin has been used for headaches and to prevent vascular disease, although it typically is used in patients who have had neurologic progression or recurrent vascular events. [ ] Aspirin needs to be used with extreme caution in children because of the risk that Reye syndrome could develop, and the risks and benefits need to be carefully weighed. Thomas-Sohl, Vaslow, and Maria have (...) recommended 3-5 mg/kg/day of aspirin for stroke-like events. They also recommended varicella and yearly influenza immunizations because of the association of varicella and influenza infections with Reye syndrome. [ ] Maria et al reported a decreased incidence of strokelike events in 20 patients with SWS who received aspirin. Of 119 strokelike events, 31 occurred in patients treated with aspirin, whereas 88 of these events occurred in those not treated with aspirin. The authors suggested further

2014 eMedicine.com

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