Another
example of Big PhARMA going after the use of aspirin. They chose an extremely rare condition (2 cases per year
since 1994) when it was not so rare because of inadequate diagnostic technique. PhARMA has ran with Reyes Syndrome as
part of
their smear aspirin—aspirin cuts in to their profits from Warfin and other
blockbusters. Every pharmacist and
doctor knows of Reye’s Syndrome, but probably less than 5% know that it is
exceedingly rare and limited to those with a metabolic disorder resulting in excessive
ammonia. {See the bracketed commentary in green}
REYES
SYNDROME
Reye's syndrome
is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver, as well as causing hypoglycemia.[1] The exact cause is unknown, and while it has been associated with aspirin consumption by children with viral illness, it also occurs in the absence of aspirin use. The disease causes fatty liver with minimal inflammation and severe encephalopathy (with swelling of the brain). The liver may become slightly enlarged and firm, and there is
a change in the appearance of the kidneys. Jaundice is not usually present.[2] {Note the symptomatic diagnosis.}
Early diagnosis is vital;
while most children recover with supportive therapy, severe brain injury or death are potential complications.
Causes
The precise mechanism
by which Reye's syndrome occurs remains unknown. This serious condition is described as a "syndrome" rather than a disease as the clinical features that physicians use to diagnose it are quite broad. The serious symptoms of Reye's syndrome appear to result from damage to cellular mitochondria,[7] at least in the liver, and there are a number of ways that aspirin could cause or exacerbate
mitochondrial damage. A potential increased risk of developing Reye's syndrome is one of the main reasons that aspirin has
not been recommended for use in children and teenagers, the age group for which the risk of lasting serious effects is highest.
No research has found a definitive cause of Reye's syndrome, and association with aspirin has only been shown through epidemological
studies. The diagnosis of "Reye's Syndrome" greatly decreased in the 1980s, when genetic testing for inborn errors of metabolism
was becoming available in first world countries.[8] A retrospective study of 49 survivors of cases diagnosed as "Reye's Syndrome" showed that the
majority of the surviving patients had various metabolic disorders.[9]
Aspirin
Some studies have demonstrated an association between aspirin
taken for viral illnesses and the development of Reye’s syndrome.[4] One small study presented findings that acetaminophen (paracetamol) is a greater risk,[5
Prognosis
Documented cases of Reye’s syndrome in adults are rare. The recovery
of adults with the syndrome is generally complete, with liver and brain function returning to normal within two weeks of the
illness. In children, however, mild to severe permanent brain damage is possible, especially in infants. Over thirty percent
of the cases reported in the United States from 1981 through 1997 resulted in fatality.
EPIDEMIOLOGY
In 1980, after CDC began cautioning physicians and parents
about the association between Reye’s syndrome and the use of salicylates in children with chickenpox or virus-like illnesses,
the incidence of Reye's syndrome in the United States began to decline. In the United States between 1980 and 1997, the number
of reported cases of Reye’s syndrome decreased from 555 cases in 1980 to about 2 cases per year since 1994. {Given this dramatic drop and diagnosis is based upon symptoms, it seems that
recent developments in diagnosis have removed many children from the pool of those who would have been labeled as having Reyes
Syndrome}. During this time
period 93% of reported cases for which racial data were available occurred in whites and the median age was six years. A viral illness occurred in 93% of cases in the preceding three
week period. For the period 1991-1994, the annual rate of hospitalizations due to Reye’s
syndrome in the US was estimated to be between 0.2 and 1.1 per million population less than 18 years of age. {This rate is inconsistent with “Reye’s syndrome decreased from 555 cases in 1980
to about 2 cases per year since 1994” same article. Almost every drug has more total sum of negative consequences than aspirin, and given the many long-term benefits,
the current warrants against aspirin usage for children are not properly founded. See for example acetaminophen--jk}
This ties together the specific, extremely rare metabolic disorder that involves
mitochondria and affects the liver, a condition that is exacerbated in children (but not adults) by taking aspirin. Reyes Syndrome is almost unknown among adults, and that this level of occurrence among children as dropped
to nearly that level because of the development of laboratory tests. Reyes syndrome
has dropped to under 1/75,000,000 children per year.* It is a medical historical
note. Thus for example, Googling in http://scholar.google.com aspirin + Reye's Syndrome, the first 3 pages had no article published later than
2000. Yet the drug industry and health associations continue to issue the warring
as though it occurs at the pre 1985 rate.--jk
* Reye’s
syndrome decreased from 555 cases in 1980 to about 2 cases per year since 1994. (http://en.wikipedia.org/wiki/Reye%27s_syndrome)
