Aspirin Strongly Implicated in Reye's Syndrome
Recommendation is Never to Take it for Chicken Pox or Flu Symptoms
Jun 28, 2009
All types of aspirin called salicylates (from the main ingredient called acetylsalicylic acid), have been linked to a condition called Reye’s Syndrome, associated with aspirin ingestion, especially by children with feverish viral diseases.
Drugs studies using acetaminophen (paracetamol outside N. A.), as well as ibuprofen and others, have only shown some unproven implications for Reye’s. And with the advent of alternative pain killers, Reye’s has become less common in recent years. Nonetheless, it is clear that even such routinely used OTC (over-the-counter) medications must be used sparingly and wisely. Headache and pain sufferers sometimes have to make tough choices.
Reye's can strike quickly, affecting all body organs, especially the brain and the liver (although usually without jaundice). It is frequently associated with the use of any form of salicylate-containing drugs (aspirin-class medications) for treating colds, fevers, and influenza-like illnesses (aspirin, easpirin, ecotrin, emperin, excedrin).
In 1974, the National Reye's Syndrome Foundation was the first citizen’s group to generate an organized lay movement to eradicate Reye's. The U.S. Surgeon General, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics, all issued recommendations to avoid using aspirin products in anyone under 19 years of age to treat episodes of fever-causing illness, especially flu or chicken pox. Most cases of Reye’s occur in children ages 4–12, usually following an upper respiratory infection or feverish infection by about 1 week.
User’s Must Check Drug Labeling for Safety
Words that might appear on drug labels containing salicylates could be any of the following: aspirin, acetylsalicylate, acetylsalicylic acid, salicylic acid, salicylate, salicylamide, or phenyl salicylates. Having Reye’s Syndrome not caused by aspirin ingestion has not been ruled out, but all documented cases have been traced back to a connection with aspirin, so recommendations were developed on that basis, although there is no data that salicylate other than aspirin has been associated with Reye's.
Symptoms to Watch For
Reye’s presents with sudden and acute brain damage (sometimes mistaken for encephalitis), liver inflammation, and symptoms that may include long bouts of vomiting. This is followed by irritability and aggression, and as the condition progresses, may lead to lethargy, confusion, loss of consciousness and coma, and mental problems or seizures with permanent brain damage.
Also noticed have been unusual placement of arms and legs, with arms extended straight and turned inward toward the body, and legs held straight with toes pointed downward. Other symptoms may mimic a stroke, including double vision, hearing loss, paralysis or muscle weakness in extremities, and speech difficulty. Immediate emergency care is necessary for early diagnosis, prevention of brain damage, or death.
There is no specific treatment for this disorder, other than to monitor the symptoms to confirm the individual’s condition. A comatose victim is considered to have suffered an acute episode, and if recovering, the overall outcome is considered good.
Only Give a Child Aspirin On a Doctor’s Instructions
Reye's Syndrome is potentially fatal in children, and the usual brain inflammation and liver damage indicate body reactions similar to poisoning. Few cases of Reye’s have been documented in adults, with most completely recovering within a few weeks. But cases in children have been serious, with permanent damage, and an average of 30 percent resulting in death.
Aspirin should be avoided for several weeks after a child has received a chickenpox vaccination or has fever symptoms, and the doctor must be given this information. OTC medications like Pepto-Bismol and anything with Wintergreen oil generally contain salicylates and should not be given to someone with either a cold or fever.
References:
Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003: 656-657.
Ferri FF. Ferri’s Clinical Advisor: Instant Diagnosis and Treatment. 2005 ed. St. Louis, Mo: Mosby; 2005:738.
Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:46-47
Michaels, MG. Reye Syndrome. In: Long SS, Pickering LK, Prober CG, eds. Principles and Practice of Pediatric Infectious Diseases. 2nd ed. Philadelphia, Pa: Churchill Livingstone; 2003:chap 50.
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