What are the CDC diagnostic criteria for Reye syndrome?

Updated: Apr 02, 2018
  • Author: Debra L Weiner, MD, PhD; Chief Editor: Kirsten A Bechtel, MD  more...
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The CDC developed the following diagnostic criteria for Reye syndrome [7, 8] :

  • Acute noninflammatory encephalopathy with an altered level of consciousness

  • Hepatic dysfunction with a liver biopsy showing fatty metamorphosis without inflammation or necrosis or a greater than 3-fold increase in alanine aminotransferase (ALT), aspartate aminotransferase (AST), or ammonia levels

  • No other explanation for cerebral edema or hepatic abnormality

  • Cerebrospinal fluid (CSF) with a white blood cell (WBC) count of 8 cells/µL or fewer (usually lymphocytes); note that lumbar puncture should not be performed in patients who are hemodynamically unstable and/or those in whom increased intracranial pressure (ICP) is a concern

  • Brain biopsy with findings of cerebral edema without inflammation or necrosis

When these criteria were developed, specific testing for other conditions was not required. Other etiologies, particularly inborn errors of metabolism (IEMs), should be ruled out before a definitive diagnosis is made.

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