A miracle, autiusm and CSM

[Guest guest]

On Behalf Of Ritchie Shoemaker

Sent: Friday, October 19, 2007

Several months ago an informed Mom brought in her 9 year old son for

evaluation of biotoxin illness. She was moldy and her brother is a

mold inspector (CIH) in land. The prior home was moldy as was

the portable classroom at the son's school. The child carried a

diagnosis of autism of some longstanding; he seemed to bright to me

to be a " typical autistic kid. " Mom had him seen by well-qualified

autism docs in land. A possible diagnosis of OCD was raised and

then PANDAS as he had a high ASO titers, but all agreed he was

autistic. He was treated with antibiotics for PANDAS and then for

Lyme, though no labs showed any Lyme antibodies. Om put him on a

diet without dyes, food colorings, additives and after finding some

foods that bothered him, kept those away too.

The child was amazing in his ability to recall birthdays of

relatives, but maybe this was just his habit. It was curious to see

how fast he rattled off birthdays of about 30 relatives, however.

Mom said she doesn't train or rehearse him to have such a memory.

He jumped up and down throughout the interview; my phlebotomist

remembers that draw to this day. His C4a was nearly 7000 (normal <

2800 in kids); MSH was too low at 9 and he had mold susceptible HLA

DR haplotype of 13-6-52A. His VCS was unreliable as he kept moving

constantly.

I told Mom that cholestyramine (CSM) doesn't treat autism, but she

wanted a prescription anyway. OK, if he is moldy and autistic, at

least the CSM would help the C4a and MSH, but not the autism, so

here's 60mg/kg three times a day. If he gets constipated or has GI

problems, stop the drug and forget this fantasy.

Today the Mom called wanting a refill of CSM Rx. Message was that

child is tolerating the drug and doing well. I called back; our

phone call was not what I expected. The child is tolerating CSM,

has stopped all stimming, now participates in social circles and is

doing well in school. He is in the gifted program. He does get

worse if he stops the diet. Mom and I agreed to stay the course of

diet and CSM, make sure he is still doing well after 2 more months,

then stop CSM over Christmas and then if doing well, back to school

off drug to assess safety.

I'm not sure how to analyze this case, Mom gently said it doesn't

matter that I don't know what to make of the child's improvement.

And she's right. Wish all cases did this nicely.

Ritch Shoemaker MD

Pocomoke, Md