Which factors suggest an inborn error of metabolism (IEM) etiology for Reye syndrome?

Updated: Apr 02, 2018
  • Author: Debra L Weiner, MD, PhD; Chief Editor: Kirsten A Bechtel, MD  more...
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Factors that increase concern for an IEM include the following:

  • No viral prodrome

  • No exposure to aspirin or toxin with association to Reye syndrome

  • Patients younger than 3 years (in particular, those younger than 1 year)

  • Patient or family history of Reye syndrome–like illness

  • Preexisting failure to thrive

  • Baseline neurologic abnormalities

  • Liver dysfunction or elevated ammonia level, particularly if elevated for longer than 1 week with or without waxing and waning

The differential diagnosis includes conditions that can cause vomiting and altered level of consciousness. The distinction between true Reye syndrome and Reye-like syndrome is often unclear.

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