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Reye's syndrome - Diagnosing Reye's syndrome

NHS Choices Medical Reference

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See your GP immediately or visit the nearest accident and emergency (A&E) department if you think your child may have Reye's syndrome

.

If your child has taken aspirin, inform your GP or the healthcare professionals that treat your child.

Ruling out other conditions

As Reye's syndrome is such a rare condition, the first stage of diagnosis is to rule out other conditions that can cause similar symptoms. For example:

  • meningitis - an infection of the meninges (the protective membranes that surround the brain and spinal cord)
  • blood poisoning - a bacterial infection of the blood
  • encephalitis - inflammation of the brain

Inherited metabolic disorders

An inherited metabolic disorder affects the chemical reactions taking place in your body. If you have a defect in one of these chemical reactions, it can cause a build-up of one type of chemical and a shortage of another type of chemical, leading to symptoms similar to those of Reye's syndrome.

The build-up of a chemical can have a toxic effect. Or you may have a shortage of a chemical vital for your normal body functions. It is therefore important that the correct diagnosis is made so that appropriate treatment can be started as soon as possible.

There will also be long-term implications for the management of the condition, such as dietary restrictions, in order to prevent further 'Reye-like' episodes occurring. Genetic counselling may be recommended, as future pregnancies or existing siblings may be affected.

The most common example of one of these inherited metabolic disorders is medium chain acyl dehydrogenase deficiency (MCADD).

Tests

During the first stage of diagnosis, blood tests and urine tests should be carried out to determine whether there is a build-up of toxins or bacteria in the blood, and to check whether the liver is functioning normally.

Special tests may be undertaken to measure the presence or absence of certain chemicals that could indicate an inherited metabolic disorder rather than Reye's syndrome. 

Other tests that may be recommended include:

These procedures are briefly described below.

CT scan

A computerised tomography (CT) scan, which produces detailed images of the body, may be used to check the pressure level in the brain.

Lumbar puncture

The CT scan may be followed by a lumbar puncture. This involves taking a sample of cerebrospinal fluid (CSF) from the base of the spine and checking to see if it has bacteria or viruses. CSF is the fluid that surrounds and protects the brain and spinal cord.

A lumbar puncture is useful for ruling out meningitis or encephalitis. However, paediatricians (specialists in conditions affecting children) will be cautious about doing a lumbar puncture if they think the child may have brain swelling.

Biopsy

Finally, a liver biopsy may be done. This involves taking a small sample of the liver so it can be closely examined under a microscope. Reye's syndrome causes distinctive changes to the cells of the liver, which can be detected using a biopsy.

Medical Review: October 30, 2012
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