Casteels-Van Daele M
Department of Paediatrics, University Hospital Gasthuisberg, Leuven, Belgium.
Eur J Pediatr. 1991 May;150(7):456-9. doi: 10.1007/BF01958420.
By analysing two patients initially diagnosed as Reye syndrome evidence is given that in some patients considered as having Reye syndrome, the syndrome is an escalation of symptoms due to viral disease and to unrecognized drug-induced encephalopathy, mainly by anti-emetics. A detailed drug history, considering all medication--not exclusively aspirin--taken during the full course of the illness is essential to differentiate between Reye syndrome and drug-induced symptoms. In addition, a critical analysis is presented of the four main case-control surveys that have lead to the proposal that salicylates are primary causative agents of Reye syndrome. In these surveys, medications given during the prodromal illness were adequately recorded, but other drugs given after the onset of vomiting have been overlooked or deliberately excluded. New epidemiological studies are needed, recording all drugs given to the patients throughout the full course of their illness until the moment of admission, in order to elucidate the mystery of Reye syndrome.
通过对两名最初被诊断为瑞氏综合征的患者进行分析，有证据表明，在一些被认为患有瑞氏综合征的患者中，该综合征是由病毒疾病以及未被识别的药物性脑病（主要由止吐药引起）导致的症状升级。详细的用药史，即考虑在疾病全过程中服用的所有药物（而非仅阿司匹林），对于区分瑞氏综合征和药物引起的症状至关重要。此外，对四项主要的病例对照研究进行了批判性分析，这些研究导致了水杨酸盐是瑞氏综合征主要致病因素的提议。在这些研究中，前驱疾病期间服用的药物得到了充分记录，但呕吐发作后服用的其他药物被忽视或故意排除。需要开展新的流行病学研究，记录患者在整个疾病过程直至入院时所服用的所有药物，以揭开瑞氏综合征之谜。
