Autism Studies and Related Medical Conditions, January 2009 - TACA

owel symptoms. Blinded comparison was made with 8 children with histologically
normal ileum and colon, 10 developmentally normal children with ileal LNH, 15 with
Crohn's disease, and 14 with ulcerative colitis. Immunohistochemistry was performed
for cell lineage and functional markers, and histochemistry was performed for
glycosaminoglycans and basement membrane thickness. RESULTS: Histology
demonstrated lymphocytic colitis in the autistic children, less severe than classical
inflammatory bowel disease. However, basement membrane thickness and mucosal
gamma delta cell density were significantly increased above those of all other groups
including patients with inflammatory bowel disease. CD8(+) density and intraepithelial
lymphocyte numbers were higher than those in the Crohn's disease, LNH, and normal
control groups; and CD3 and plasma cell density and crypt proliferation were higher
than those in normal and LNH control groups. Epithelial, but not lamina propria,
glycosaminoglycans were disrupted. However, the epithelium was HLA-DR(-),
suggesting a predominantly T(H)2 response. INTERPRETATION: Immunohistochemistry
confirms a distinct lymphocytic colitis in autistic spectrum disorders in which the
epithelium appears particularly affected. This is consistent with increasing evidence for
gut epithelial dysfunction in autism.
Cavataio F, Carroccio A, Iacono G.: Milk-induced reflux in infants less than one year
of age. J Pediatr Gastroenterol Nutr 2000;30 Suppl:S36-44
Abstract: 1st Divisione Pediatria, Gastroenterologia, Ospedale dei Bambini G. Di
Cristina, Palermo, Italy.
Cow's milk allergy (CMA) and gastroesophageal reflux are considered to be among the
most common disturbances in infants less than 1 year of age. In recent years, the
relationship existing between these two entities has been investigated and some
important conclusions have been reached: In just under half the cases of GER in infants
less than 1 year of age there is an association with CMA; in a high proportion of cases,
GER is not only CMA-associated but also CMA-induced; the frequency of this association
should induce pediatricians to screen for possible concomitant CMA in all infants with
GER less than 1 year old; with the exception of some patients with mild typical CMA
manifestations (diarrhea, dermatitis, or rhinitis), the symptoms of GER associated with
CMA are the same as those observed in primary GER; immunologic tests are useful in a
suspected association between GER and CMA; and subjects with GER secondary to CMA
show a typical pH-monitoring tracing pattern, characterized by a progressive, slow
decrease in esophageal pH between feedings. This article reviews the main features of
the two diseases, stressing the aspects in common between them and comments on all
the listed points.
NOTE: Reflux appears to be common in infants later dx'd with autism.
Autism Studies & Related Medical Conditions – TACA © Page 154