A child suffered from viral illness for which he was given aspirin. Three days later the child was brought to the emergency with altered sensorium and icterus. What is the underlying biochemical defect?
**Core Concept**
Aspirin is a salicylate that can lead to the development of Reye's syndrome, a rare but serious condition characterized by brain and liver dysfunction. This condition is associated with the use of aspirin in children during viral infections.
**Why the Correct Answer is Right**
Reye's syndrome is caused by the accumulation of fatty deposits in the mitochondria of liver cells, leading to impaired mitochondrial function and energy production. This is due to the inhibition of mitochondrial respiratory chain enzymes by the salicylate metabolite of aspirin. The brain and liver are particularly susceptible to the toxic effects of salicylates, resulting in the characteristic symptoms of Reye's syndrome, including altered sensorium and icterus.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify the underlying biochemical defect in Reye's syndrome. While fatty acid metabolism is indeed affected, it is not the primary cause of the condition.
**Option B:** This option is incorrect because it refers to a different condition altogether, where the accumulation of fatty deposits in the liver leads to liver failure. This is not the underlying defect in Reye's syndrome.
**Clinical Pearl / High-Yield Fact**
Reye's syndrome is a serious condition that highlights the importance of avoiding aspirin in children during viral infections. The condition can be prevented by using alternative antipyretic and anti-inflammatory medications.
**Correct Answer:** D. Accumulation of fatty deposits in the mitochondria of liver cells, leading to impaired mitochondrial function and energy production.