RESUMO
Se describe el caso de una mujer joven atendida en el hospital San Ignacio (Santa Fe de Bogotá), con diagnostico post mortem de síndrome de Reye. Seguidamente, se revisan y discuten los aspectos fisiopatológicos y los concernientes al diagnóstico y la terapéutica.
Assuntos
Humanos , Feminino , Adulto , Vírus da Influenza B/patogenicidade , Síndrome de Reye/complicações , Síndrome de Reye/diagnóstico , Síndrome de Reye/epidemiologia , Síndrome de Reye/etiologia , Síndrome de Reye/fisiopatologia , Síndrome de Reye/mortalidade , Síndrome de Reye/patologia , Síndrome de Reye/tratamento farmacológico , Síndrome de Reye/terapiaRESUMO
Se revisan los conceptos actuales sobre este enigmatico padecimiento que ha motivado estudios de investigacion en los aspectos metabolicos de la intimidad del hepatocito para establecer las alteraciones estructurales y enzimaticas que se desarrollan en su intimidad mitocondrial explicando algo de la patogenia al atribuir a la hiperamonemia el papel relevante en las manifestaciones encefalopaticas del cuadro clinico, de las cuales depende en gran manera el pronostico y que obligan a su control terapeutico especialmente con la monitorizacion de la presion intracraneana. El estudio estadistico realizado en gran escala en USA apunta a la intervencion de la aspirina como el factor importante que juntamente con la participacion de los virus de la influenza o la varicela conducen a la eclosion de este cuadro clinico hasta hace poco tiempo de evolucion muy grave, pero que inexplicablemente no se lo observa en otros ambientes como el nuestro donde la varicela o la influenza son enfermedades epidemicas y el uso de la aspirina tiene una vigencia tradicional por su empleo indiscriminado hasta el presente.
Assuntos
Síndrome de Reye , Bolívia , Síndrome de Reye/epidemiologia , Síndrome de Reye/patologiaRESUMO
An unusual cluster of Reye syndrome was associated with an outbreak of influenza A (H1N1) infections in the state of Colorado. Two of the 16 affected children had had prior episodes of Reye syndrome following respiratory infections, and one had had transverse myelitis following varicella. A serologic study of patients treated at a children's hospital and serum specimens submitted to the state health department revealed that approximately 59% of children in Colorado had been infected with the H1N1 strain of influenza A over a two-year period. Based upon this serologic survey, the minimum and maximum rates of Reye syndrome associated with H1N1 infections were calculated to be 2.5 and 4.3 cases per 100,000 H1N1 infections, respectively. A retrospective analysis of admissions to four referral hospitals in Denver failed to reveal any unusual clustering of Reye syndrome with outbreaks of influenza A H3N2 infections during 1975-1978. The reason for an association between Reye syndrome and the H1N1 strain but not the H3N2 strains of influenza A remains unclear.
Assuntos
Influenza Humana/complicações , Síndrome de Reye/epidemiologia , Adolescente , Criança , Pré-Escolar , Colorado , Feminino , Humanos , Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A/isolamento & purificação , Influenza Humana/epidemiologia , Masculino , Síndrome de Reye/diagnóstico , Síndrome de Reye/etiologiaRESUMO
The treatment of 66 children with Reye syndrome proved by hepatic biopsy or autopsy is described. Prior to the utilization of exchange transfusion early in the course of the disease, our case fatality rate was 100% of nine patients. With early diagnosis and early exchange transfusion, the case fatality rate was reduced to 27% of 44 patients. During the 1974 epidemic of Reye syndrome, 26 children were treated. In 18 children the diagnosis was established by hepatic biopsy; 16 received one or more exchange transfusions. There were no deaths among these 26 patients. In the 1974 epidemic, the national case fatality rate was estimated to be 40%. Exchange transfusion appears to have been an important factor in the reduction of the case fatality rate among our patients.