Abstract

PHARMACOLOGICAL INSIGHTS INTO GREY BABY SYNDROME AND REYE’S SYNDROME: IMPLICATIONS FOR PEDIATRIC CARE

Shaikh Aklakh G.*, Vani Gauri N., Mundhe Vaishnavi B., Gavhane Gauri S., Thorat Pratiksha M., Lokhande Anuradha A. and Kavitake Pradeep N.

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Abstract

Grey Baby Syndrome (GBS) and Reye’s Syndrome (RS) are rare but life-threatening pediatric conditions associated with specific drug exposures—chloramphenicol and aspirin, respectively. This paper presents a comparative analysis of GBS and RS, examining their pharmacological origins, pathophysiology, clinical features, epidemiology, diagnosis, treatment, and prevention. GBS occurs primarily in premature neonates due to immature liver enzyme systems incapable of adequately metabolizing chloramphenicol, resulting in toxic accumulation and cardiovascular collapse. In contrast, RS typically affects children recovering from viral infections such as influenza or varicella, particularly when aspirin is administered. RS is characterized by acute non-inflammatory encephalopathy and hepatic mitochondrial dysfunction, leading to increased intracranial pressure and liver failure. Though both syndromes involve hepatic dysfunction and can rapidly progress to fatal outcomes, their mechanisms differ—GBS is due to direct drug toxicity, while RS results from a metabolic disturbance. Diagnosis in both conditions relies heavily on clinical presentation and supportive laboratory findings, though RS often necessitates neuroimaging and liver biopsy. Management strategies also diverge: GBS requires immediate cessation of chloramphenicol and supportive care, while RS demands intensive care with a focus on managing intracranial pressure and correcting metabolic imbalances. Preventive measures for both conditions emphasize appropriate drug use: avoiding chloramphenicol in neonates and restricting aspirin use in children. Public health interventions, education on safe pediatric pharmacotherapy, and improved diagnostic vigilance are crucial for reducing the incidence and severity of these syndromes. Understanding their distinct characteristics is essential for timely intervention and improved outcomes in pediatric care.

Keywords: Pediatric pharamacology, Pediatric adverse reactions, Drug toxicity, Clinical managements, Asprin toxicity, Chloramphenicol toxicity.