Citation, DOI, disclosures and article data
Citation:
Bell D, Reynolds pentad. Reference article, Radiopaedia.org (Accessed on 14 Aug 2024) https://doi.org/10.53347/rID-147933
Reynolds pentad is a combination of clinical signs found in acute cholangitis. It consists of Charcot triad 2-4:
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fever and/or chills
- RUQ pain
- jaundice
as well as:
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delirium or lethargy, and
- shock
Usefulness
Sensitivity of Reynolds pentad from a large systematic review of nine studies was found to be 4.82%. Data was not felt to be of good enough quality to calculate its specificity 2.
In general neither Charcot triad nor Reynolds pentad is thought to be particularly useful in the diagnosis of acute cholangitis 1-3.
History and etymology
In 1959, Benedict M Reynolds (1925-2019), and Everett L Dargan (fl. 2022), American general surgeons working in New York City, published this pentad, in a small case series of four patients, all of whom had an obstructive cholangitis due to calculi 4,5.
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1. Thuluvath A, Ahn J, Rattan P et al. Evaluation of Charcot Triad, Reynolds Pentad, and Tokyo Guidelines for Diagnosis of Cholangitis Secondary to Choledocholithiasis Across Patient Age Groups. Mayo Clin Proc Innov Qual Outcomes. 2021;5(2):377-87. doi:10.1016/j.mayocpiqo.2021.01.008 - Pubmed
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2. Rumsey S, Winders J, MacCormick A. Diagnostic Accuracy of Charcot's Triad: A Systematic Review. ANZ J Surg. 2017;87(4):232-8. doi:10.1111/ans.13907 - Pubmed
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3. Rosing D, De Virgilio C, Nguyen A, El Masry M, Kaji A, Stabile B. Cholangitis: Analysis of Admission Prognostic Indicators and Outcomes. Am Surg. 2007;73(10):949-54. - Pubmed
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4. Reynolds B & Dargan E. Acute Obstructive Cholangitis; a Distinct Clinical Syndrome. Ann Surg. 1959;150(2):299-303. doi:10.1097/00000658-195908000-00013 - Pubmed
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5. Benedict Reynolds Obituary (1925–2019) – The Journal News. The Journal News. Published 16 April 2019. Accessed 23 June 2022. https://obits.lohud.com/amp/obituaries/lohud/192398762
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