Reye syndrome - Revision history

ClaireLewis: /* Evaluation */

2019-09-14T15:32:37Z

Evaluation

← Revisión anterior		Revisión del 15:32 14 sep 2019
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	*[[Acetaminophen toxicity\|Acetaminophen]] level (rule out coingestion/alternate cause of liver failure)		*[[Acetaminophen toxicity\|Acetaminophen]] level (rule out coingestion/alternate cause of liver failure)
	*[[Salicylate toxicity\|ASA]] level (rule out overdose)		*[[Salicylate toxicity\|ASA]] level (rule out overdose)
	*Fingerstick (can be [[hypoglycemic]])		*Fingerstick (can be [[hypoglycemia\|hypoglycemic]])
	*[[UDS]]		*[[UDS]]
	*[[LP]]		*[[LP]]

ClaireLewis at 15:32, 14 September 2019

2019-09-14T15:32:23Z

← Revisión anterior		Revisión del 15:32 14 sep 2019
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	==Background==		==Background==
	*Potentially fatal syndrome		*Potentially fatal syndrome
	*~~Effects to many organs~~, especially ~~the~~ brain and liver		*Associated with [[aspirin]] use during [[viral syndrome\|viral illness]], especially [[influenza]], [[varicella]]
	*Associated with aspirin taken for viral illness		*Multiorgan system disease, particularly effects brain and liver
	*Classic ~~Early Symptoms~~:		*Classic early symptoms: [[rash]], [[vomiting]], [[liver failure\|liver damage]] (without [[jaundice]] typically)<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref>
	**Rash
	**Vomiting
	**Liver damage
	*Jaundice is not usually present<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref>

	==Clinical Features==		==Clinical Features==
	*Five Stages<ref>http://emedicine.medscape.com/article/803683-overview</ref>		*Stage I
	**Stage I		**[[Rash]] on palms of hands and feet
	***Rash on palms of hands and feet		**Persistent, heavy [[vomiting]]
	***Persistent, heavy vomiting		**[[Altered mental status]], [[confusion]], generalized [[lethargy]]
	***altered mental status, ~~Confusion~~, ~~Generalized~~ lethargy		**High [[fever]]
	***High fever		*Stage II
	**Stage II		**Stupor
	***Stupor		**[[Hyperventilation]]
	***Hyperventilation		**Fatty liver (found by biopsy)
	***Fatty liver (found by biopsy)		*Stage III
	**Stage III		**Possible [[coma]]
	***Possible coma		**Possible cerebral edema
	***Possible cerebral edema		**Rarely, [[respiratory arrest]]
	***Rarely, respiratory arrest		*Stage IV
	**Stage IV		**Deepening [[coma]]
	***Deepening coma		**Dilated pupils with minimal response to light
	***Dilated pupils with minimal response to light		**Minimal hepatic dysfunction
	***Minimal ~~but still present~~ hepatic dysfunction		*Stage V
	**Stage V		**Deep [[coma]]
	***Deep coma		**[[Seizures]]
	***Seizures		**Multisystem organ failure[7]
	***Multiple organ failure[7]		**[[Weakness\|Flaccidity]]
	***Flaccidity		**Hyperammonemia (above 300mg/dL of blood)
	***Hyperammonemia (above 300mg/dL of blood)		*Death
	**Death

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Shaken baby syndrome]]		*[[Shaken baby syndrome]]
	*Head trauma		*[[Head trauma (peds)\|Head trauma]]
	*[[Viral encephalitis]]		*[[Viral encephalitis]]
	*[[Meningitis]]		*[[Meningitis]]
	*Drug overdose or poisoning		*Drug overdose or poisoning
	*~~Various inborn metabolic disorders~~		*[[Inborn errors of metabolism]]

	==Evaluation==		==Evaluation==
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	*Chem 10		*Chem 10
	*ABG		*ABG
	*~~Liver Panel~~		*[[LFTs]]
	*Ammonemia		*Ammonemia
	*Acetaminophen ~~Level~~		*[[Acetaminophen toxicity\|Acetaminophen]] level (rule out coingestion/alternate cause of liver failure)
	*ASA ~~Level~~		*[[Salicylate toxicity\|ASA]] level (rule out overdose)
	*Fingerstick (can be hypoglycemic)		*Fingerstick (can be [[hypoglycemic]])
	*~~Urine Tox~~		*[[UDS]]
	*LP		*[[LP]]
	*[[ECG]]		*[[ECG]]
	*EEG (coma)		*EEG (coma)
Línea 60:		Línea 55:
	==Management==		==Management==
	===ABCs===		===ABCs===
	*Consider ~~Intubation with Stage~~ II		*Consider [[intubation]] if stage II or higher
	*Ensure IV access with fluid resus		*Ensure IV access with fluid resus
	*~~Aggressive~~ cerebral edema ~~monitoring and treatment~~		*Monitor neuro status closely, treat signs of cerebral edema aggressively

	===Consultations===		===Consultations===
	*Consider NSG Consult for ~~Cerebral Edema~~		*Consider NSG Consult for cerebral edema
	*Consider GI consult for liver biopsy		*Consider GI consult for liver biopsy
	*Consider ~~Metabolic Disorders~~		*Consider metabolic disorders

	==Also See==		==Also See==

Rossdonaldson1: Text replacement - "ECG" to "ECG"

2016-09-09T08:06:12Z

Text replacement - "*ECG" to "*ECG"

← Revisión anterior		Revisión del 08:06 9 sep 2016
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	*Urine Tox		*Urine Tox
	*LP		*LP
	*ECG		*[[ECG]]
	*EEG (coma)		*EEG (coma)

Rossdonaldson1: Text replacement - "AMS" to "altered mental status"

2016-07-31T06:41:34Z

Text replacement - "AMS" to "altered mental status"

← Revisión anterior		Revisión del 06:41 31 jul 2016
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	***Rash on palms of hands and feet		***Rash on palms of hands and feet
	***Persistent, heavy vomiting		***Persistent, heavy vomiting
	***~~AMS~~, Confusion, Generalized lethargy		***altered mental status, Confusion, Generalized lethargy
	***High fever		***High fever
	**Stage II		**Stage II

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-25T19:56:32Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 19:56 25 jul 2016
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	*Various inborn metabolic disorders		*Various inborn metabolic disorders

	==~~Diagnosis~~==		==Evaluation==
	*CBC		*CBC
	*Chem 10		*Chem 10

Neil.m.young: Text replacement - "0 mg" to "0mg"

2016-07-20T16:31:52Z

Text replacement - "0 mg" to "0mg"

← Revisión anterior		Revisión del 16:31 20 jul 2016
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	***Multiple organ failure[7]		***Multiple organ failure[7]
	***Flaccidity		***Flaccidity
	***Hyperammonemia (above ~~300 mg~~/dL of blood)		***Hyperammonemia (above 300mg/dL of blood)
	**Death		**Death

Rossdonaldson1: Text replacement - "==Clinical Presentation==" to "==Clinical Features=="

2016-07-12T21:53:53Z

Text replacement - "==Clinical Presentation==" to "==Clinical Features=="

← Revisión anterior		Revisión del 21:53 12 jul 2016
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	*Jaundice is not usually present<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref>		*Jaundice is not usually present<ref>Suchy, FJ, el al.; Sokol, RJ; Balistreri, WF (2007). Liver Disease in Children. Cambridge: Cambridge University Press. ISBN 0-521-85657-4.</ref>

	==Clinical ~~Presentation~~==		==Clinical Features==
	*Five Stages<ref>http://emedicine.medscape.com/article/803683-overview</ref>		*Five Stages<ref>http://emedicine.medscape.com/article/803683-overview</ref>
	**Stage I		**Stage I

Neil.m.young at 16:01, 18 May 2016

2016-05-18T16:01:28Z

← Revisión anterior		Revisión del 16:01 18 may 2016
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	*[[Meningitis]]		*[[Meningitis]]

	==~~Sources~~==		==References==
	*Uptodate
	*http://emedicine.medscape.com/article/803683-overview -- last accessed 1/4/15
	<references/>		<references/>

	[[Category:ID]]		[[Category:ID]]
	[[Category:Pediatrics]]		[[Category:Pediatrics]]

Neil.m.young at 16:00, 18 May 2016

2016-05-18T16:00:56Z

← Revisión anterior		Revisión del 16:00 18 may 2016
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	*Drug overdose or poisoning		*Drug overdose or poisoning
	*Various inborn metabolic disorders		*Various inborn metabolic disorders

			==Diagnosis==
			*CBC
			*Chem 10
			*ABG
			*Liver Panel
			*Ammonemia
			*Acetaminophen Level
			*ASA Level
			*Fingerstick (can be hypoglycemic)
			*Urine Tox
			*LP
			*ECG
			*EEG (coma)

	==Management==		==Management==
	===ABCs===		===ABCs===
	*Consider Intubation with Stage II		*Consider Intubation with Stage II
	*IV access with fluid resus		*Ensure IV access with fluid resus
			*Aggressive cerebral edema monitoring and treatment
	===Consultations===		===Consultations===
	*Consider NSG Consult for Cerebral Edema		*Consider NSG Consult for Cerebral Edema

Neil.m.young at 15:58, 18 May 2016

2016-05-18T15:58:33Z

← Revisión anterior		Revisión del 15:58 18 may 2016
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	==Management==		==Management==
	*ABCs		===ABCs===
	**Consider Intubation with Stage II		*Consider Intubation with Stage II
	*IV access with fluid resus		*IV access with fluid resus
	*Fingerstick		===Consultations===
	** hypoglycemic - dextrose 25% bolus of 1-2 mL/kg
	*CBC
	*Chem 10
	*ABG
	*EKG
	*Liver Panel
	*Ammonemia
	**aggressive cerebral edema monitoring and treatment
	*LP
	*Urine Tox
	*Acetaminophen Level
	*ASA Level
	*EEG (coma)
	*Consider Central Line
	*Consider NSG Consult for Cerebral Edema		*Consider NSG Consult for Cerebral Edema
	*Consider GI consult for liver biopsy		*Consider GI consult for liver biopsy