Fwd: Critical Work of Dr. Wakefield Replicated

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*Critical Work of Dr. Wakefield Replicated*

Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children

with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms

www.la-press.com/article.php?article_id=1816

Authors: Arthur Krigsman, Marvin Boris, Alan Goldblatt and Carol Stott

Publication Date: 27 Jan 2010 Autism Insights 2010:2 1-11

Abstract Background: Children with developmental disorders experience

chronic gastrointestinal symptoms.

Aims: To examine the nature of these gastrointestinal symptoms and

histologic findings in children with autism spectrum/developmental disorders

and ileocolonic disease.

Methods: Chart review. 143 autism spectrum/developmental disorder

patients, with chronic gastrointestinal symptoms, undergoing diagnostic

ileocolonoscopy.

Results: Diarrhea was present in 78%, abdominal pain in 59% and

constipation in 36%. Ileal and/or colonic lymphonodular hyperplasia (LNH),

defined as the presence of an increased number of enlarged lymphoid

follicles, often with hyperactive germinal centers, was present in 73.2%.

Terminal ileum LNH presented visually in 67% and histologically in 73%.

Colonic LNH was multifocal and presented histologically in 32%. Ileal and/or

colonic inflammation presented in 74%, consisting primarily of active or

chronic colitis (69%). Ileal inflammation presented in 35%. Presence of LNH

significantly predicted mucosal inflammation. Patients with ileal and/or

colonic LNH had lower mean/median age than those without; patients with

ileal and/or colonic inflammation had lower mean/median age than those

without. There was a significant association between ileo and/or colonic

inflammation or LNH, and onset of developmental disorder; plateaued or

regressive onset conferred greater risk than early onset.

Conclusions: Patients with autism or related disorders exhibiting

chronic gastrointestinal symptoms demonstrate ileal or colonic inflammation

upon light microscopic examination of biopsy tissue. Further work is needed

to determine whether resolution of histopathology with appropriate therapy

is accompanied by GI symptomatic and cognitive/behavioral improvement.

+ Full paper here: http://www.la-press.com/article.php?article_id=1816

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