Allergic manifestations in autistic children: Relation to disease severity

Article type: Research Article

Authors: Mostafa, Gehan A. | Hamza, Rasha T. | El-Shahawi, Heba H.

Affiliations: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt | Department of Neuropsychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Note: [] Correspondence: Gehan A. Mostafa, M.D., Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Tel.: +20 222713217, +20 222877301, +20 103512877; E-mail: hafezg@softhome.net; rashatarif_2000@hotmail.com

Abstract: Etiology of autism has become an area of significant controversy. Allergy may play a role in the pathogenesis of autism wherein allergic immune responses to some proteins (e.g., dietary proteins and latex) may induce the production of brain autoantibodies, which are found in many autistic children. This study was conducted to investigate the frequency of allergic manifestations in autistic children. The relationship between allergy and disease characteristics in terms of disease severity, clinical findings and electroencephalography (EEG) abnormalities was also studied. Fifty autistic children (30 had mild to moderate autism and 20 had severe autism) were studied in comparison to 50 age- and sex- matched children without neuropsychiatric manifestations serving as controls. Clinical evaluation was done with special emphasis on neuropsychiatric assessment and clinical manifestations of allergy. Serum total immunoglobulin E was measured in all studied subjects. In addition, EEG and assessment of mental age were done for all autistic children. Allergic manifestations (bronchial asthma, atopic dermatitis and/or allergic rhinitis) were found in 52% of autistic patients. This frequency was significantly higher than that of controls (10%; P < 0.001). There was a significant positive association between the frequency of allergic manifestations and disease severity, important clinical findings elicited in some autistic children (gastrointestinal symptoms and neurological manifestations) and EEG abnormalities. In conclusion, the frequency of allergic manifestations is increased in autistic children. The significant positive association between these manifestations and important disease characteristics (disease severity, gastrointestinal symptoms, neurological findings and EEG abnormalities) may shed light on the possible causal role of allergy in some autistic children. Indeed, we need to know more about the links between allergy, immune system and brain in autism. This is important to determine whether therapeutic modulation of immune function and allergic diseases are legitimate avenues for novel therapy in selected cases of autism or even for attempted primary prevention in genetically at risk subgroups.

Keywords: Autism, allergy, autistic severity, serum IgE

Journal: Journal of Pediatric Neurology, vol. 6, no. 2, pp. 115-123, 2008