Reye’s syndrome with aspirin: one man's meat is another man's poison

Aspirin is a drug with multiple uses. At low dose, it is used as an anti platelet. It has analgesic, anti-pyretic and anti-inflammatory actions in a wide dose range. However, aspirin is not the drug choice for fever in any age group. Paracetamol is considered safer. In children, it is more true because aspirin has been found to be associated with Reye’s syndrome when used as antipyretic in children suffering from chickenpox, influenza and other viral illness. In such illness, aspirin may cause hepatic mitochondrial damage. There is inhibition of fatty acid metabolism and increase in serum ammonia levels. Hyperammonemia may induce diffuse cerebral edema and raised intracranial pressure. The child presents with profuse vomiting, stupor which may rapidly progress to coma, cardio respiratory failure and death.