Reye syndrome revisited: a descriptive term covering a group of heterogeneous disorders

Reye syndrome, characterised by the combination of liver disease and noninf lammatory encephalopathy, is a non-specific clinicopathological entity and a descriptive term covering a group of heterogeneous disorders. Nowadays, s ome of these patients are diagnosed more correctly as having infectious, me tabolic, toxic or other disease. The non-specific case definition implies t hat the epidemiological studies suggesting a link with acetylsalicylic acid have been performed on a heterogeneous group of children, whereby the valu e of these studies and their ensuing hypothesis is weakened. Moreover, a de tailed analysis of the epidemiological surveys of the Centers for Disease C ontrol, the Yale study and of the British risk factor study provides eviden ce that not only the use of acetylsalicylic acid but also that of phenothia zines and other anti-emetics is significantly greater in Reye syndrome case s than in controls. As to the decline of Reye syndrome, recent literature d ata reveal that this is related to more accurate modern diagnosis of infect ious, metabolic or toxic disease, reducing the percentage of idiopathic or true cases of Reye syndrome. Conclusion Reye syndrome is a non-specific descriptive term covering a grou p of heterogeneous disorders. Moreover, not only the use of acetylsalicylic acid but also of antiemetics is statistically significant in Reye syndrome cases. Both facts weaken the validity of the epidemiological surveys sugge sting a link with acetylsalicylic acid.