To the Editor. —
The JOURNAL has presented convincing evidence from case-control studies that aspirin use among children increases the risk for Reye's syndrome.1-3 In recent years, there has been a dramatic decline in the reported incidence of Reye's syndrome nationally, which has paralleled the decline in the use of aspirin.4 More recently, Sienko et al5 reported further supporting population-based evidence for the association between aspirin and Reye's syndrome, stating that decreasing aspirin use has made Reye's syndrome an "endangered syndrome." We would like to address the possible concern regarding children who routinely take aspirin for chronic illnesses.Two studies6,7 have shown that children who take aspirin routinely are at increased risk of Reye's syndrome. While the prevalence of juvenile rheumatoid arthritis (JRA) has been estimated to range from 0.1 to 1.1 per 1000 children,6 a hospital-based study7 of Reye's syndrome found a disproportionate
Sullivan KM, Remington PL, Hurwitz ES, Halpin TJ. Reye's Syndrome Among Patients With Juvenile Rheumatoid Arthritis. JAMA. 1988;260(23):3434–3435. doi:10.1001/jama.1988.03410230052017
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