REYE-LIKE SYNDROME IN THREE-YEAR-OLD CHILD

The article reviews the literature on classical and atypical Reye’s syndrome, explores the circumstances that contribute to its  occurrence, provides criteria for diagnosing with an illustration in the form of an authentic case of Reye-like disease in a child of 3 years  old. Reye’s syndrome is a disease manifested by acute  encephalopathy in combination with fatty degeneration of the  internal organs, mainly the liver. This condition was first described in  1963 by an Australian pathologist who identified 21 cases of the  disease in children with influenza A who were taking acetylsalicylic  acid, 17 children died. In the future, the circle of infections that  preceded the development of Reye’s syndrome-acute respiratory  infections, chickenpox, entero- and rotavirus infections, in rare  cases, hepatitis A and HIV, bacterial infections: mycoplasma,  chlamydia, whooping cough, shigella, salmonella. Drugs that can cause the development of this syndrome: tetracycline,  zidovudine, diclofenac sodium, mefenamic acid, paracetamol,  amiodarone, warfarin, phenothiazine derivatives, histaminolytics  (dimedrol), valproic acid. Along with drugs, insecticides, herbicides,  hepatotoxic fungi can be used as triggers of the syndrome. There is  an age dependence of the development of this syndrome. The  pathogenesis of classic Reye’s syndrome is associated with  generalized damage to the mitochondria primarily in the brain, as well as in the liver, kidneys, muscles, myocardium and pancreas,  with the disturbance of oxidation of fatty acids in them and the  formation of fat degeneration of varying degrees. In addition to the  classic Reye’s syndrome, atypical Reye’s syndrome or Reye-like  disease is isolated, occurs in children under 5 with congenital  disturbance of oxidation of fatty acids. We observed in our clinic the  case of Reye-like disease in a girl of three years with infection and  taking antipyretics. In the discussion section, the features of the  given case are noted, the question of the appropriateness (in view of the generality of the clinic and the mechanisms of development) of  dividing the syndrome into classical and atypical is discussed. A new  name for both conditions is proposed — Reye’s disease in honor of  the discoverer, highlighting its two forms with an early and late  onset. Given the morphological changes in this syndrome —  steatosis of internal organs — authors seem to be appropriate  measures aimed at treating secondary mitochondrial insufficiency  and fatty dystrophy.

1. Зборовский АБ, Тюренков ИН, Белоусов ЮБ. Неблагоприятные побочные эффекты лекарственных средств. Медицинское информационное агенство. М.; 2008. [Zborovskiy AB, Tyurenkov IN, Belousov YuB. Adverse drug reaction. Meditsinskoye informatsionnoye agentstvo = Medical News Agency. Moscow; 2008 (In Russ.)]

2. Weiner DL, Bechtel KA. Reye syndrome. Med-Scape; 2018 [cited 21 Jan 2018]. Available at: https://emedicine.medscape.com/article/803683-overview

3. Ikeda K, Sonoda K. A case of Reye’s-like syndrome due to suspected Bordetella pertussis infection in an adult. Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases. 2009,83(6):658–60.

4. Jones DB, Mullick FG, Hoofnagle JH, Baranski B: Reye’s syndrome-like illness in a patient receiving amiodarone. Am J Gastroenterol. 1988;83:967–70.

5. Schmidt D. Anticonvulsants. In: Dukes MNG, ed. Meyler’s side effects of drugs. 12th ed. Amsterdam: Elsevier;1992:122–43.

6. Casteels-Van Daele M, Van Geet C, Wouters C, et al. Reye syndrome revisited: a descriptive term covering a group of heterogeneous disorders. Eur J Pediatr. 2000;159:641–8.

7. Reye syndrome — NORD (National organisation for rare disorders); 2018 [cited 21 Jan 2018]. Available at: https://rarediseases.org/rare-diseases/reye-syndrome/

8. Руина ЕА, Густов АВ, Смирнов АА, Логанова АГ. Рецидивирующий синдром Рейе у взрослого мужчины — трудности диагностики (клинический случай). Медицинский Альманах. 2016;5:141–5. [Ruina EA, Gustov AV, Smirnov AA, Loganova AG. Recurrent Reye syndrome in an adult male — difficulties in diagnosis (clinical case). Meditsinskiy Al’manakh = Medical Almanac. 2016;5:141–5 (In Russ.)]

9. National Reyes Syndrome Foundation UK. Workshop on Reye’s syndrome and Reye-like inherited disorders 2018 [cited 21 Jan 2018]. Available at: www.reyessyndrome.co.uk

10. Eadie MJ, McKinnon GE, Dunstan PR, MacLaughlin D, Dickinson RG. Valproate metabolism during hepatotoxicity associated with the drug. Q J Med. 1990 Dec;77(284):1229–40.

11. Matsumoto J, Ogawa H, Maeyama R, Okudaira K, Shinka T, Kuhara T, Matsumoto I. Successful Treatment by Direct Hemoperfusion of Coma Possibly Resulting From Mitochondrial Dysfunction in Acute Valproate Intoxication. Epilepsia. 1997;38:950–3.

12. Osterloh J, Cunningham W, Dixon A, Combest D. Biochemical relationships between Reye’s and Reye’s-like metabolic and toxicological syndromes. Med Toxicol Adverse Drug Exp. 1989 Jul- Aug;4(4):272–94.

13. Saranya R, Avabratha KS, Varghese AD, Rai BS. Hepatic encephalopathy: An enigma. Muller J Med Sci Res. 2013;4:111–2.

14. Brown JK, Imam H. Interrelationships of Liver and Brain with Special Reference to Reye Syndrome. In: Harkness RA, Pollitt RJ, Addison GM. (eds) Journal of Inherited Metabolic Disease. 1991.

15. Jia-Woei Hou. Primary systemic carnitine deficiency presenting as recurrent Reye-like syndrome and dilated cardiomyopathy. Journal: Chang Gung Med J. 2002 Dec;25(12):832–7.

16. Gosalakkal JA, Kamoji V. Reye syndrome and Reyelike syndrome. Pediatr Neurol. 2008;39:198–200.

17. Sukru A, Cengizhan K, Huseyin B, Dursun O. Clinical Presentation, Treatment and Prognosis in Children with Reye-like Syndrome. J Clin Anal Med. 2014;5.(3):191–4.

18. Запруднов АМ. Синдром Рея в детском возрасте. Парацетамол в педиатрической практике. М.: Стерлинг хелс; 1995. С. 59. [Zaprudnov AM. Reye’s syndrome in childhood. Paracetamol in pediatric practice. Moscow: Sterling Heath; 1995; 59 (In Russ.)]

19. Радченко ВГ, Селиверстов ПВ, Иванова ВФ, Ситкин СИ. Алгоритм лечения неалкогольной жировой болезни печени и роль митохондриальной дисфункции в ее развитии. Фарматека. 2017;6:14–21. [Radchenko VG, Seliverstov PV, Ivanova VF, Sitkin SI. Algorithm for the treatment of non-alcoholic fatty liver disease and the role of mitochondrial dysfunction in its development. Farmateka. 2017;6:14–21. (In Russ.)]

20. Тодоров Й. Клинические лабораторные методы исследования в педиатрии. София: Медицина и физкультура; 1968. [Todorov J. Clinical laboratory methods of research in pediatrics. Sofia: Medicine and Physical Education; 1968 (In Russ.)]

21. Горелов АA, Усенко ДA. Ротавирусная инфекция у детей. Вопросы современной педиатрии. 2015;7(6):78–84. [Gorelov AA, Usenko DA. Rotavirus infection in children. Voprosy sovremennoy pediatrii = Questions of modern pediatrics. 2015;7(6):78–84 (In Russ.)]

22. Glasgow JF, Middleton B, Moore R, Gray A, Hill J. The mechanism of inhibition of beta- oxidation by aspirin metabolites in skin fibroblasts from Reye’s syndrome patients and controls. Biochim Biophys Acta. 1999 May 31;1454(1):115–25.

23. Pugliese A, Beltramo T, Torre D. Reye’s and Reye’s-like syndromes. Cell Biochem Funct. 2008 Oct;26(7):741–6.

24. Булатов ВП, Фазлеева ЛК, Алиева МН, Саттарова ЛИ, Солоненко АП. Состояние миокарда новорожденных после перинатальной гипоксии и методы коррекции постгипоксической патологии сердца. Вопросы современной педиатрии. 2008;5. [Bulatov VP, Fazleeva LC, Alieva MN, Sattarova LI, Solonenko AP. The state of the myocardium of newborns after perinatal hypoxia and methods of correction of posthypoxic cardiac pathology. Voprosy sovremennoy pediatrii = Questions of modern pediatrics. 2008;5 (In Russ.)]

25. Оскирко АН, Кишкурно ЕП, Комир ВВ, Млявая ТВ. Синдром Рея в педиатрической практике. Медицинский журнал. 2012;1:139–48. [Oskirko AN, Kishkurno EP, Komir VV, Mlyavaya TV. Reye’s syndrome in pediatric practice. Meditsinsky jurnal = Medical Journal. 2012; 1: 139–48 (In Russ.)]

26. Bzduch V, Behulova D, Lehnert W, Fabriciova K, Kozak L, Salingova A, et al. Metabolic cause of Reye-like syndrome. Bratisl Lek Listy. 2001;102(9):427–9.

27. Ашихмин ЯИ, Щекочихин ДЮ. Рекомендации 2016 года по лечению дислипидемий (ESC/EAS): фокус на применение нестатиновой гиполипидемической терапии. Фарматека. 2017;6:20–5. [Ashikhmin YaI, Shchekochikhin DYu. 2016 Guidelines for the Treatment of Dyslipidemia: focus on the use of non-statin lipid-lowering therapy. Farmateka. 2017;6:20–5 (In Russ.)]

28. Стаценко МЕ, Туркина СВ, Тыщенко ИА, Фабрицкая СВ, Полетаева ЛВ. Возможности медикаментозной коррекции вторичной митохондриальной дисфункции у пациентов с ишемическойболезнью сердца и коморбидной патологией. Фарматека. 2017;6:75–80. [Statsenko ME, Turkina SV, Tyshchenko IA, Fabritskaya SV, Poletaeva LV. Possibilities of medicamentous correction of secondary mitochondrial dysfunction in patients with coronary artery disease and comorbid pathology. Farmateka. 2017;6:75–80 (In Russ.)]

29. Лобзин СВ, Головкин ВИ, Попова ЛО. Карнитин и его производные при цереброваскулярных заболеваниях. Российский семейный врач. 2013;1:40–4. [Lobzin SV, Golovkin VI, Popova LO. Carnitine and its derivatives in cerebrovascular diseases. Russian family doctor. 2013;1:40–4 (In Russ.)]. http://dx.doi.org/10.17816/RFD2013140-44

30. Ушкалова ЕА. Место эссенциальных фосфолипидов в современной медицине. Фарматека. 2003;10(73):40–6. [Ushkalova EA. Place of essential phospholipids in modern medicine. Farmateka. 2003; 10 (73): 40–6 (In Russ.)]