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Posted

Just wondering, in case I missed somehting, is there any reason why it couldn't be Reye's Syndrome?

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Posted

Reye's is a multi-factal mitochondria associated encephalomyopathy involving children, viral infections, and aspirin. Symptoms can include vomiting, coma, hepatomegaly, and hypoglycemia. Mitochondria related etiology mostly involves disruption in the mitochonria protein import complexes.

Posted

This pt has not taken any aspirin, only tylenol and motrin. Why would he have Reye's?

Posted

Symptoms fit so far (vomiting, declining LOC, I'm sure I'm missing some because the course was focused on the mechanism more) with a commnity infection consistant with a viral infection. The parents at this time don't seem to be the best historians since they seem to be adding things every 5 minutes or so. Also, (browsing though a few different websites), it seems that it's not just ASA, but salicylic acid in general [http://www.reyessyndrome.org/aspirin.htm] that is related to Reye's. This includes pepto bismol.

Besides, I think it would be cool if something I learned about a few weeks ago was a solution to the scenario.

Edit: grammar, clarifications

Posted

Doc, doesn't pepto have a derivative of Salycilates in it?

Posted

True cmk but salicylates have been associated with Reyes for a long time if I remember reading that somewhere.

So even though the salicylates in pepto are non-aspirin they still have the feasible possibility to cause Reyes.

From EMED article I posted above

Background: Salicylates are ubiquitous agents found in hundreds of over-the-counter (OTC) medications and in numerous prescription drugs. Salicylic acid and its derivatives are active ingredients in a wide variety of readily available topical preparations used for the treatment of pain, warts, and acne. Pepto-Bismol, a common antidiarrheal agent, contains 131 mg of salicylate per tablespoon.

Salicylate ingestion continues to be a common cause of poisoning in children and adolescents. The prevalence of aspirin-containing analgesic products makes these agents, found in virtually every household, common sources of both accidental and suicidal ingestion

So an overdose of aspirin or salycilates(I can't seem to get that spelling right) with a side order of possible reyes syndrome is entirely possible for this kid.


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