Blinded By Reye’s

Although aspirin generally comes with a warning against its use by children – due largely to an historical association with Reye’s Syndrome –  there is much evidence suggesting a very different story.

According to one study from a Florida paediatric hospital, Reye’s Syndrome(RS) was a ‘rare disease which…disappeared…in the late 1980s. An association between Reye’s syndrome and the ingestion of aspirin was claimed, although no proof of causation was ever established.’

The study went on to state that the presence of aspirin has not been shown to be in the blood of RS patients and that ‘no animal model of Reye’s syndrome has been developed where aspirin causes the disease’.

Other studies have shown a far greater correlation between RS and paracetamol (acetaminophen) use, and epidemiological evidence seems to show that the disease was in significant decline long before warnings against aspirin use began.

“The diagnosis of Reye’s syndrome was confirmed pathologically in 42 of 49 cases (86%). Aspirin or salicylate ingestion occurred in only 4 (8%), and paracetamol (acetaminophen) ingestion in 12 (24%)…”

Aspirin has long been used as a preventative measure for children at risk of stroke, or a high risk of embolism due to congenital or acquired cardiac disease, and it appears that there are ‘no published examples of children who developed Reye’s syndrome while taking prophylactic aspirin.’

“Aspirin is used more than other antiplatelet agents in children, largely because of years of experience with aspirin and the lack of evidence that other agents are more effective.”

The 1980s campaign warning against aspirin use by children appears to have coincided with a dramatic increase in the sale of newer more profitable drugs like Tylenol or Panadol.

“Reye’s syndrome disappeared from countries where aspirin was not used in children as well as from countries which continued to use aspirin in children.”

There is, however, evidence showing increased levels of polyunsaturated fats (PUFAs) in the blood of children with Reye’s Syndrome, suggesting the possibility that aspirin therapy (being highly protective against the inflammatory breakdown products of the PUFAs) might be an effective and reasonable approach to treatment.

“Increased concentrations of polyunsaturated fatty acids have been found in sera from patients with RS.”

“Serial measurements of total serum free fatty acids (FFA) showed that levels were increased during RS and, after recovery, were significantly lower in the patients who survived…The increase in polyunsaturated fatty acids in FFA, the precursors of prostaglandins, suggests that a grossly disturbed prostaglandin pattern may occur in RS.”

A diet restricting the intake of PUFAs, and providing sufficient protein, sugar, and other nutrients (from sweet ripe fruits, fruit juice, milk, cheese, honey, white sugar, and some well cooked starchy vegetables like white potatoes) – in order to help avoid exposure to excessive levels of free fatty acids – appears to be a logical and rational approach to optimizing health and preventing disease in children, including Reye’s.

I’m not a doctor or nutritionist, and none of this is intended as medical advice. Always consult your doctor in case of illness, or before making medical and pharmaceutical decisions.

Have you seen any science effectively showing a causative relationship between aspirin use and the onset of RS?

See more here.

Is aspirin a cause of Reye’s syndrome? A case against.

A catch in the Reye.

Stroke in Children.

Aspirin, Reye syndrome, Kawasaki disease, and allergies; a reconsideration of the links.

An aspirin a day to prevent prematurity.

Reye’s syndrome: a case control study of medication use and associated viruses in Australia.

Effects of peroxidized polyunsaturated fatty acids on mitochondrial function and structure: pathogenetic implications for Reye’s syndrome.

Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from Phase Three of the ISAAC programme.

Relationship of Oxidant and Antioxidant Markers to Asthma Severity in Egyptian Asthmatic Children.

Biomarkers of lipid peroxidation, airway inflammation and asthma.

Abnormal polyunsaturated fatty acid patterns of serum lipids in Reye’s syndrome.

Investigation of an epidemic of Reye’s syndrome in northern region of India.

Reye’s syndrome in Bangalore.

Malondialdehyde in Exhaled Breath Condensate as a Marker of Oxidative Stress in Different Pulmonary Diseases.

Effect of aspirin on airway inflammation and pulmonary function in patients with persistent asthma.

Evidence that Increased Acetaminophen use in Genetically Vulnerable Children Appears to be a Major Cause of the Epidemics of Autism, Attention Deficit with Hyperactivity, and Asthma.

Aspirin and Reye syndrome: a review of the evidence.

The Reye syndrome.

Aspirin and Decreased Adult-Onset Asthma.

Reye syndrome: rate of oxidation of fatty acids in leukocytes and serum levels of lipid peroxides.

[Asthma relieved by aspirin].

The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism.

Prenatal exposure to acetaminophen and respiratory symptoms in the first year of life.

Whatever happened to Reye’s syndrome? Did it ever really exist?

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Image: Picmonic