Do Adults Get Reye’s Syndrome?

Reye’s syndrome usually occurs in children under age 10. It is considered as a childhood illness that strikes without any warning. Reye’s syndrome in an adult is a rare phenomenon. However, some cases occurred in non-pediatric age groups. During the early 1980s, Reye’s predominantly is seen in young adults between 18 to 46 years old. The incidence in young adolescent is different in several regions of the world and depends on the genetic susceptibility and exogenous subjects. Diagnostic and management of Reye’s disease in adults is problematical because physician often they confuse with the symptoms of the other syndrome and requires high index of suspicion. In general, it begins with viral infection followed by vomiting and encephalopathy associated liver dysfunction. On the other hand, encephalopathy may result in permanent neurological damage especially in the adult like memory, loss of vision, and hearing problem.

Research studies during the last seven decades have strained the significance of differential diagnosis of unsolved encephalopathy and Reye’s syndrome. There was evidence obtained from a period between 1976 and 1983 when Reye’s was in decline phase. But, later expert confirmed Reye’s in adults was no rarer as earlier assumed. Varicella zoster, cytomegalovirus, influenza and B, and dengue were some of the virus that caused infection in adults who are all aged between 18 to 46 years old. Multiple drug overdoses, valproic acid hepatotoxicity, alcohol abuse with acetaminophen, connective tissue disease with chronic salicylate ingestion, ornithine transcarbamylase deficiency, systematic carnitine deficiency, chronic pancreatitis, and obesity with dehydration are some of the triggering factor diagnosed among adult individuals associated with Reye’s. Increased levels of serum aminotransferases, prolonged prothrombin time, elevated blood ammonia levels, and characteristic microvesicular fatty liver and mitochondrial changes also diagnosed among adults.

Based on the differential diagnosis report, the expert confirmed that Reye’s was more difficult to identify in adults. It was a complicated procedure and chance of confusion was more. But a percutaneous liver biopsy was very helpful in the diagnosis of Reye’s syndrome in adult.

Occupational toxin was reasoned for causing Reye’s syndrome in adult. Urban and sub-urban were not of etiologic importance. Rural populations were seen to be affected more. The prognosis in adult was good when compared to that children. In many cases, drugs were screened in which therapeutic level of acetoacylic acid was positive. Hypoglycemia found commonly in children and rare in adults. Patients have shown high blood ammonia levels exceeding five times than individuals. Some cases of adult Reye’s syndrome caused aggressive behavior, severe neurological impairment, high rate of depression, anxiety, and offensive verbal languages reported. Death cases among young adolescent and coma stage five also found. Sufferers in stage I or II coma were treatable, but uneventful recovery and has a poor outlook. In cases of non‐Reye’s encephalopathy, drug ingestion presented as one of the most difficult differential diagnostic problems, which also included alcohol abuse, collagen vascular disease, and hepatitis B surface antigenemia.

Center for Disease Control, USA indicated in its publication that Reye’s syndrome has apparently changed its age pattern incidence between 1973 to 1978. Earlier underage children and infants were more affected, but later young teenagers and adults become vulnerable to this disease. This alerted physician if any age patients presented with encephalopathy. One of the astonishing cases in Reye’s incidence history was 26-year-old female shown Reye’s with AIDS syndrome. So, far only one case has been reported in Reye’s case history i.e., hepatitis A infection association.

Reye’s syndrome in recent years is extremely rare and the incidence rate in adults is very less when compared to children. Maybe well developed natural immunity is the reason and survival rate has risen more than 80%. The condition is no more threat if diagnosed and treated much earlier.

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