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Laboratory Examination On Syndrome Reye

An elevated ammonia level 24-48 hours after symptom onset is the most common laboratory abnormality in Reye syndrome. Ammonia levels peak at 56-60 hours and may return to normal in later stages. Liver enzymes ALT and AST are elevated to three times normal but may become normal again later. Bilirubin is higher than 2 mg/dL in 10-15% of patients. Prolonged prothrombin time and activated partial thromboplastin time occur in over 50% of patients. Low levels of coagulation factors may be seen due to liver dysfunction. Urine specific gravity is increased and ketonuria is present in 80% of patients. Cerebrospinal fluid white blood cell

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21 views1 page

Laboratory Examination On Syndrome Reye

An elevated ammonia level 24-48 hours after symptom onset is the most common laboratory abnormality in Reye syndrome. Ammonia levels peak at 56-60 hours and may return to normal in later stages. Liver enzymes ALT and AST are elevated to three times normal but may become normal again later. Bilirubin is higher than 2 mg/dL in 10-15% of patients. Prolonged prothrombin time and activated partial thromboplastin time occur in over 50% of patients. Low levels of coagulation factors may be seen due to liver dysfunction. Urine specific gravity is increased and ketonuria is present in 80% of patients. Cerebrospinal fluid white blood cell

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Hardeep Parmar
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© Attribution Non-Commercial (BY-NC)
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LABORATORY EXAMINATION ON SYNDROME REYE

An ammonia level as high as 1.5 times normal 24-48 hours after the onset of mental status changes is the most frequent laboratory abnormality. Ammonia tends to peak 56-60 hours after the onset of symptoms. The ammonia level may return to normal in stages 4 and 5. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase to 3 times normal but may return to normal by stages 4 or 5. Bilirubin levels are higher than 2 mg/dL (but usually lower than 3 mg/dL) in 10-15% of patients. If the direct bilirubin level is more than 15% of total or if the total bilirubin level exceeds 3 mg/dL, consider other diagnoses. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are prolonged more than 1.5-fold in more than 50% of patients. Levels of factors I (fibrinogen), II, VII, IX, and X may be low because of the disruption of synthetic activities in the liver. Consumption may also contribute to low levels of coagulation factors. Platelet counts are usually normal. Lipase and amylase levels are elevated. The serum bicarbonate level is decreased secondary to vomiting. Blood urea nitrogen (BUN) and creatinine levels are elevated. Glucose, while usually normal, may be low, particularly during stage 5 and in children younger than 1 year. Lactic dehydrogenase (LDH) levels may be high or low. Levels of free fatty acids and amino acids (eg, glutamine, alanine, and lysine) may be elevated. Determine the anion gap and venous blood gas level to evaluate for metabolic acidosis. Urine specific gravity is increased; 80% of patients have ketonuria. Cerebral spinal fluid WBC count, by disease definition, does not exceed 8 cells/L.Opening pressure is usually normal but may be elevated, particularly in stages 3-5. Recognize that these derangements are not specific for Reye syndrome and may suggest other etiologies that should be considered.

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