Is Aspirin a Cause of Reye??s Syndrome?

Abstract

Reye's syndrome was a rare disease which appeared suddenly in the early 1950s and disappeared just as suddenly in the late 1980s. An association between Reye's syndrome and the ingestion of aspirin (acetylsalicylic acid) was claimed, although no proof of causation was ever established. The presence of salicylates in the blood or urine of Reye's syndrome patients has not been demonstrated, and no animal model of Reye's syndrome has been developed where aspirin causes the disease. It is clear from epidemiological data that the incidence of Reye's syndrome was decreasing well before warning labels were placed on aspirin products. 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. Reye's syndrome was probably either a viral mutation which spontaneously disappeared, or a conglomeration of metabolic disorders that had not been recognized or described at that time.

Medicine-taking behaviour and drug-related problems in adolescents of a Swedish high school

“…Although acetaminophen and ibuprofen were most commonly chosen by our adolescents, some reported using acetylsalicylic acid, which is contraindicated for fever in adolescents \18 years of age, due to the risk of Reye's Syndrome [23]. This contraindication has, however, also been questioned [24]. In the study by Huott and Storrow in the US, recognition of the potential for overdose lethality of specific OTC medications, such as aspirin and acetaminophen, was limited, while adolescents commonly believed many other OTCs, e.g.…”

Theoretical aspects of autism: Causes—A review

“…Children given acetaminophen after the MMR II vaccine were significantly more likely to become autistic than children given ibuprofen. Aspirin was not involved because it was not considered safe for infants and young children after being implicated in Reye's syndrome (liver and brain damage after viral infection) in the 1980s (Good, 2009) [However, others offered compelling arguments that aspirin was not the cause of Reye's syndrome (Orlowski et al, 2002)]. During pregnancy, mothers of autistic children commonly suffer more bacterial and viral infections (Rodier, 2000) and fevers (Torres, 2003), which could affect the fetus to predispose the child for autism (Meyer et al, 2006).…”

Toxicity and Drug Safety

“…However, reports on patients with related diseases had already been published sporadically since 1929 [437]. It had been speculated that the sudden appearanceand disappearanceof Reyes syndrome fits best with a precipitous mutation in a virus [438]. It had been speculated that the sudden appearanceand disappearanceof Reyes syndrome fits best with a precipitous mutation in a virus [438].…”

“…This includes aspirin and acetaminophen, both subject to hepatic metabolism and both being potentially hepatotoxic, though by quite different mechanisms (Section 3.2.2). The differing opinions of whether these warnings are (still) justified are discussed in greater detail in several overviews [438,441,[444][445][446][447]. In any case, the search for a possible association between Reyes syndrome and aspirin became an issue of epidemiologicaldimensions.…”

“…A Reye-like disease, except a few sporadic reports, did not exist (or was not reported) for any significant extent before 1950 and disappeared in the late 1980s [438,480]. The reasons for this rise and fall are a matter of heavy controversies, and this in particular with respect to the role of aspirin.…”