All issues > Volume 27(5); 1984

Original Article

J Korean Pediatr Soc. 1984;27(5):457-466. Published online May 31, 1984.

Reye's Syndrome in Children.

Dong Jin Lee¹, Sook Hee Lee¹, Ja Hoon Koo¹, Doo Hong Ahn¹, Yong Jin Kim²

¹Department of Pediatrics, College of Medicine, Kyungpook National University Taegu, Korea
²Department of Pathology, College of Medicine, Kyungpook National University Taegu, Korea

Abstract

A clinical observation has been made on 44 children with Reys's syndrome who were admitted to pediatric department of KNU hospital during 6 year period from September 1977 to August 1983. Male to female ratio was 1.3 : 1. Cases under 6 years of age comprised 40(90.9%) and cases under 1 year 13(29.6%). The most common antecedent illness was URI including ainfluenza” (65.9%), followed by diarrhea and herpangina in small number of cases. Clinical manifestations showed vomiting(86.4%), fever(77.3%), convulsion(75.0%) hepatomegaly(65.9%) and tachypnea or respiratory distress(36.4%) in order of frequency, and hypoglycemia was seen in 38.6%. Difference of clinical manifestations between age group under 1 year and over 1 year showed tachypnea being more frequent in the age group under 1 (p< .005). However, other parameters including vomiting, convulsion and hypoglycemia did not show any statistical difference between two groups. As concomittant illnesses and complications, renal involvement was the most common one occuring in 12 cases (27.3%), with 8 showing acute renal failure. Case fatality ratios according to the stage on admission showed 0% in stage I, 8.3% in stage II, 25% in stage III, 50% in stage IV, and 0% in stage V. The same ratio according to the deepest stage during hospitalization showed 0% in stage I, II, III, 25% in stage IV, and 53.8% in stage V. Death and severe complication occurred more frequently in patients with high blood ammonia level over 300 pg/dl (p<. 005). However, there was no statistically significant difference between patient's outcome and level of CPK, LDH, SGOT and SGPT. Also, statistically significant correlationship (p< .025) was found between renal involvement and outcome. Other parameters which might be related to patient's outcome including age of patients, duration of onset of illness to mental change, hypoglycemia and CSF pressure, did not show any prognostic significance.

Keywords :Reye’s syndrome; Encephalopathy; Acute renal failure