What Causes Hyperammonemia?
Discussion
Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes which includes personality changes, agitation/combativeness, disorientation and insomnia. As the levels continue to rise (150-200 mg/dL) loss of consciousness and seizures can occur. At levels of 200-400 mg/dL coma and respiratory failure can occur.
RS occurs after a previous viral illness, especially varicella or influenza, usually during the recovery phase. Research in the 1970s and 80s determined that salicylates (aspirin) were a major risk factor for RS although the mechanism is still not understood. Warning labels were added to salicylate products in the US starting in 1986. Aspirin is therefore not recommended for use for most acute childhood illnesses and has been replaced by acetaminophen or ibuprofen. Similar products such as bismuth subsalicylate products also should be used with great care at any time particularly around the time of a viral illness. ...
Source: PediatricEducation.org - Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
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