All issues > Volume 30(11); 1987

Original Article

J Korean Pediatr Soc. 1987;30(11):1252-1258. Published online November 30, 1987.

Factors Influencing the Prognosis of Reye Syndrome.

Chang Ho Hong¹, Heung Dong Kim¹, Pyung Kil Kim¹

¹Department of Pediatrics, Yon sei University, College of Medicine, Seoul, Korea

Abstract

While the etiology of Reye syndrome is still unknown, wide variations in both the clinical spectrum and the therapeutic outcome of patients have been noted. We reviewed the cases of 42 Reye syndrome patients who were admitted to Young Dong Severance Hospital during the period from April, 1983 to July, 1986 and analyzed factors influencing the prognosis of Reye syndrome. The patients were divided into three groups: Group 1 included fully recovered patients, group 2 patients experienced cerebral damage such as motor disturbances, mental retardation, hearing or visual disturbances and those patients expired were placed in group 3. Comparisons of clinical and laboratory data among the groups were made and the following results were obtained. 1) Of the 42 cases, there were 26 cases (61.9%) in group 1, four cases (9.5%) in group 2 and 12 cases (28.6%) in group 3. 2) Males were affected more frequently than females with ratio of 1.4 :1. Among the groups, there were no statistically significant differences by age. 3) Among the antecedent illnesses of Reye syndrome, respiratory diseases comprised 81% (34 cases), gastroenteritis 9.5%, and chickenpox 2.4%. There was no significance among them. The relationship between rotavirus and Reye syndrome was especially studied, but no statistical significance was noted. 4) There was a significant relationship in seizure and unconsciousness between groups 1, and 2 and group 3 (p< .05). 5) The concentration of blood NH3 was related to the severity of Reye syndrome, especially when the NH3 concentration was greater than 300㎍/dl (p< .05). 6) Neurologic staging is important in the prognosis. The stage on admission progressed rapidly through several stages of unconsciousness before and while therapeutic measures were instituted. In this study, all patients in group 2 and 3 were in either stage IV or V, the deepest stage of Reye syndrome. 7) There was statistical significance in the duration of hyperammonemia and unconsciousness in group 2 as compared to group 1.

Keywords :Reye syndrome; Prognosis