GI problems/family history of Autoimmune disease

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Gastrointestinal Problems and Family History of Autoimmune Disease Are More

Common in Children with Autistic Spectrum Disorder with Language Regression Than

Those Without Regression

Valicenti-McDermott, McVicar, Herbert Cohen, Isabelle Rapin, Barry

Wershil, Shlomo Shinnar. Kennedy Center, AECOM, Bronx, NY; Pediatrics/CHAM,

AECOM, Bronx, NY; Neurology, AECOM, Bronx, NY.

BACKGROUND: Gastrointestinal problems(GI), including an autoimmune colitis,

occurred at higher frequency in children with Autistic Spectrum Disorder(ASD),

but there is no comparative data between children with and without history of

language regression(LR).

OBJECTIVE: To compare the clinical characteristics, frequency of GI symptoms,

and its relationship to family history of autoimmune disorders in children with

ASD with or without a history of LR.

DESIGN/METHODS: Cross sectional study with structured interview in 100 children

with ASD. Interview included: Childhood Autism Rating Scale(CARS), GI

Questionnaire, and Familial Autoimmune Questionnaire. Language regression was

defined as the parental report of loss of any words.

RESULTS: Of the 100, 25 had history of LR and 82 were male. Mean age was 9.6 y.

Children with LR had a higher CARS than those without LR (39.3 vs 36.3, p=0.03)

Only 40% of children with LR were toilet trained compared to 72% non-LR

(p=0.03). Overall, 68% had one or more GI complaint. Children with LR have more

GI problems (84% vs 61% p=0.04), especially chronic diarrhea (40 % vs 12%

p=0.006) and increased number of bowel movements (1.9 1 vs 1.3 1 p=0.03).

Family history of celiac disease or inflammatory bowel disease was greater in

children with LR (24% vs 0 p=0.001). Fourteen percent of the total group had

food allergies (LR 24% vs noLR 11% p=0.2). Family history of autoimmune disease

was present in 34% of children with ASD. Rheumatoid arthritis was higher in

those with LR (30% vs 11% p=0.03) with no differences in the frequency of other

autoimmune disorders. Of the 8 children with family history of autoimmune

disease and LR, 6(75%) also had history of chronic diarrhea compared with 4(16%)

of the 25 with family history of autoimmune disease and no LR (p=0.023).

CONCLUSIONS: Children with ASD with history of LR have a higher rate of GI

symptoms, in particular chronic diarrhea, than children with ASD without a

history of LR. Family history of rheumatoid arthritis was elevated in those with

LR. There is an association between children with LR, family history of

autoimmune disease and chronic diarrhea, which suggests a shared autoimmune

pathophysiology.