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Published on: December 7, 2018
Autism medical comorbidities
1Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama P.O. Box 26671, Bahrain, Bahrain.
Insights
Children with autism spectrum disorder (ASD) often have co-occurring medical conditions, including genetic, neurological, and gastrointestinal disorders. Addressing these health issues is crucial for improving learning and overall well-being in children with ASD.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Medical Genetics
Background:
- Children with autism spectrum disorder (ASD) exhibit a higher prevalence of medical comorbidities compared to the general population.
- Specific genetic disorders like Fragile X syndrome and Down syndrome are more common in children with ASD.
- Neurological conditions such as epilepsy, cerebral palsy, and congenital abnormalities are frequently observed in individuals with ASD.
Discussion:
- Sleep disorders affect approximately 80% of individuals with autism, significantly impacting their daily lives.
- Gastrointestinal (GI) issues, including constipation, diarrhea, and reflux, are highly prevalent, occurring in 46% to 84% of children with ASD.
- Inborn errors of metabolism, neuroinflammation, immune abnormalities, and allergic disorders are also more common in children with ASD, potentially influencing symptom severity and behavior.
Key Insights:
- The co-occurrence of various medical conditions in ASD necessitates a holistic approach to patient care.
- Identifying and treating comorbidities like GI problems, sleep disturbances, and allergic disorders can improve behavioral outcomes and learning.
- The presence of anti-brain antibodies suggests a potential pathoplastic mechanism in autism.
Outlook:
- Early identification and management of medical comorbidities in children with ASD are essential for optimizing developmental trajectories.
- Further research into the interplay between genetic factors, immune responses, and neurological development in ASD is warranted.
- A comprehensive medical evaluation should precede other interventions to ensure children with ASD receive appropriate and integrated care.
Abstract:
Medical comorbidities are more common in children with autism spectrum disorders (ASD) than in the general population. Some genetic disorders are more common in children with ASD such as Fragile X syndrome, Down syndrome, Duchenne muscular dystrophy, neurofibromatosis type I, and tuberous sclerosis complex. Children with autism are also more prone to a variety of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headaches, and congenital abnormalities of the nervous system. Besides, sleep disorders are a significant problem in individuals with autism, occurring in about 80% of them. Gastrointestinal (GI) disorders are significantly more common in children with ASD; they occur in 46% to 84% of them. The most common GI problems observed in children with ASD are chronic constipation, chronic diarrhoea, gastroesophageal reflux and/or disease, nausea and/or vomiting, flatulence, chronic bloating, abdominal discomfort, ulcers, colitis, inflammatory bowel disease, food intolerance, and/or failure to thrive. Several categories of inborn-errors of metabolism have been observed in some patients with autism including mitochondrial disorders, disorders of creatine metabolism, selected amino acid disorders, disorders of folate or B12 metabolism, and selected lysosomal storage disorders. A significant proportion of children with ASD have evidence of persistent neuroinflammation, altered inflammatory responses, and immune abnormalities. Anti-brain antibodies may play an important pathoplastic mechanism in autism. Allergic disorders are significantly more common in individuals with ASD from all age groups. They influence the development and severity of symptoms. They could cause problematic behaviours in at least a significant subset of affected children. Therefore, it is important to consider the child with autism as a whole and not overlook possible symptoms as part of autism. The physician should rule out the presence of a medical condition before moving on to other interventions or therapies. Children who enjoy good health have a better chance of learning. This can apply to all children including those with autism.
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