Reye’s like Syndrome in an Adult; a Forgotten Entity
Journal Title: Journal of Clinical & Medical Case Reports - Year 2015, Vol 2, Issue 2
Abstract
We report a case of 25 years old Caucasian lady who was admitted with history of use of non-steroidal anti-inflammatory drug for a viral like illness, repeated vomiting and hypokalemia. Her endoscopy showed pyloric stenosis for which she had surgery. 2 weeks after her surgery she became confused and had generalised tonic-clonic seizures. Her blood tests showed deranged liver function tests. Her lumbar puncture, autoimmune screen and viral PCR were negative. Her imaging was normal and her EEG showed slowing of the background activity consistent with diffuse encephalopathy. Her ammonia level was noted to be persistently high and there was a gradual deterioration of liver functions. Because of hyperammonia she was extensively investigated for inborn error of metabolism. Her tests were normal apart from high levels of glutamine. She had a liver ultrasound which showed fatty infiltration. A presumptive diagnosis of Reye’s-like syndrome was made in view of her past history of viral like illness, analgesic overuse, persistent vomiting, hyperammonia, hepatic dysfunction, fatty liver and encephalopathy with low CSF white cell count. She was managed on intensive care with neuroprotective ventilation, haemofiltration to clear the ammonia and nutritional support. She eventually improved 2 months from the onset of symptoms. Reye’s syndrome (RS) is an acute illness characterized by hepatic encephalopathy and fatty degeneration of the liver. It occurs in children but also has been reported in adults. It often occurs after viral infections treated with acetylsalicylic acid and NSAID. This case report alerts the Emergency staff and internists to the possibility of Reye’s like syndrome in an adult person. The diagnosis of Reye’s syndrome is not straightforward. It requires high index of suspicion and is usually a diagnosis of exclusion.
Authors and Affiliations
Gul Bano
Keywords
Related Articles
- EP ID EP207611
- DOI 10.13188/2332-4120.1000012
- Views 177
- Downloads 0
Reye’s like Syndrome in an Adult; a Forgotten Entity
We report a case of 25 years old Caucasian lady who was admitted with history of use of non-steroidal anti-inflammatory drug for a viral like illness, repeated vomiting and hypokalemia. Her endoscopy showed pyloric steno...
Spontaneous Perinephric Haemorrhage (Wunderlich Syndrome) Secondary to Upper Pole Renal Angiomyolipoma: A Rare Life Threatening Situation: Case Report and Discussion
Wunderlich Syndrome is a rare condition in which spontaneous renal haemorrhage occurs into the subcapsular and perirenal spaces in absence of trauma. It can present as a life threatening situation with profound shock whi...
Prenatal Diagnosis of Vesicoureteral Reflux: Role of Combined Ultrasound Study and Next Generation Sequencing in Clinical Characterization. The Application of NGS in Prenatal Diagnosis
Background: Pathophysiology and clinical prognosis of congenital anomalies of the kidney and urinary tract are known, especially in adult. Recent studies using massively sequencing approach in adult are clarifying geneti...
Alcohol Abuse, Reproductive Coercion and Intimate Partner Violence: Case Reports and Mini-Review
This article presents a continuation of report series on alcohol abuse, reproductive coercion and intimate partner violence. The abortion rate in the former Soviet Union has been the highest in the world, caused not only...
Recurrent Multiple Complex Anal Fan-Shape Fistula
Introduction: Fortunately, recurrent multiple complex anal fistula is an uncommon pathology; however, it is at times frankly impossible to cure and entails considerable fear regarding application of thetherapeutic option...