A 6-year-old boy recovering from chickenpox is given aspirin by his parents for fever. Three days later he develops persistent vomiting, lethargy, and hepatomegaly with a two-fold rise in transaminases and hypoglycaemia. The complication that has been precipitated is:

• A Acute viral hepatitis from the varicella virus
• B Salicylate intoxication with metabolic acidosis only
• C Reye syndrome ✓
• D Haemolytic uraemic syndrome

Explanation

Aspirin use during viral illnesses, especially influenza and varicella, in children is associated with Reye syndrome: encephalopathy with cerebral oedema and fatty change in the liver, with vomiting, hypoglycaemia and raised transaminases. Simple salicylism presents with tinnitus and hyperventilation rather than hepatic steatosis and encephalopathy. Because of this risk, paracetamol is the recommended antipyretic in children with febrile viral illness.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.