Reynolds pentad

Last revised by Dr Daniel J Bell on 23 Jun 2022

Reynolds pentad is a combination of clinical signs found in acute cholangitis. It consists of Charcot triad 2-4:

  1. fever and/or chills
  2. RUQ pain
  3. jaundice

as well as:

  1. delirium or lethargy, and
  2. 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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