The current warning that aspirin should not be given to children under the age of 12 should be extended to include teenagers. This is the view of Dr Susan Hall (honorary lecturer in paediatrics, Sheffield Children's hospital) and Mr Richard Lynn (epidemiologist, Royal College of Paediatrics and Child Health, London).
In a letter to the New England Journal of Medicine (1999;341:845), they say that, since June, 1986, 17 cases of Reye's syndrome associated with aspirin exposure were reported in the UK. In 10 of the 17 cases, the patient was a teenager.
Reye's syndrome, an acute encephalopathy associated with fatty change of the liver, can be fatal or cause brain damage. It occurs typically after viral infections, such as influenza and chickenpox. The precise cause of Reye's syndrome is unknown but its development has been linked to the use of aspirin during viral infections. In 1986, the Committee on Safety of Medicines advised that aspirin should not be given to children under 12 except on medical advice.
Dr Hall told The Journal on September 13 that Reye's syndrome could occur at any age, although it was relatively more common in children. In the US, the warning on aspirin containing products stated that they were not suitable for children and teenagers. Dr Hall felt that the UK warning should similarly include teenagers.
The data used by Dr Hall were collated by the British Paediatric Surveillance Unit, which was established in July, 1986, to collect reports of uncommon childhood disorders. Dr Hall was previously the medical co-ordinator for the unit. She said that the findings had been drawn to the attention of the Medicines Control Agency (MCA) and it was now "up to the regulatory authorities to make a final decision on the age recommendation".
The MCA told The Journal on September 15 that it was "keeping the situation under careful review". In addition, it said: "Any change in the recommendations for the use of aspirin requires careful consideration of the available evidence because of the rarity of Reye's syndrome."