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Gastrointestinal manifestations and their relation to faecal calprotectin in children with autism
Hanan Galal Azouz1, Nermine Hossam El-Din Zakaria2, Ahmed Fouad Khalil1
1Department of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Insights
Gastrointestinal problems are common in children with autism spectrum disorder (ASD). Fecal calprotectin (FC) levels, a marker for gut inflammation, are higher in ASD children and correlate with symptom severity.
Area of Science:
- Pediatric Gastroenterology
- Neurodevelopmental Disorders
- Biomarker Research
Background:
- Gastrointestinal (GI) problems are a frequent comorbidity in children with autism spectrum disorder (ASD).
- A potential link between active GI inflammation and ASD has been proposed.
- Fecal calprotectin (FC) serves as a non-invasive biomarker for detecting GI inflammation.
Purpose of the Study:
- To investigate fecal calprotectin (FC) levels as a marker of bowel inflammation in children with ASD.
- To explore the relationship between FC levels and the presence and severity of GI manifestations in ASD.
Main Methods:
- Stool samples were analyzed for FC levels in 40 children with ASD and 40 age- and sex-matched healthy controls.
- Autism severity was evaluated using the Childhood Autism Rating Scale (CARS).
- GI symptom severity was assessed using a modified 6-Item Gastrointestinal Severity Index (6-GSI) questionnaire.
Main Results:
- 82.5% of children with ASD reported GI symptoms, with offensive stool odor being most common (70%).
- Elevated FC levels were found in 35% of ASD children compared to 25% of controls, with significantly higher mean FC levels in the ASD group.
- FC levels positively correlated with GI symptom severity (6-GSI) in ASD patients, and CARS scores correlated with 6-GSI scores.
Conclusions:
- GI manifestations are highly prevalent in children with ASD.
- Children with ASD exhibit significantly elevated FC levels, indicating increased intestinal inflammation.
- FC levels strongly correlate with the severity of GI symptoms in ASD, suggesting inflammation as a potential cause.
Introduction:
A common comorbidity in autism spectrum disorder (ASD) children is gastrointestinal problems, and a possible link between active gastrointestinal inflammation and autism has been suggested. Faecal calprotectin (FC) is a non-invasive marker for of gastrointestinal inflammation.
Aim:
To study the level of FC as a marker of bowel inflammation in children with ASD and its possible relation to gastrointestinal manifestations.
Material And Methods:
Calprotectin levels were assessed in stool samples of 40 ASD children. Autism severity was assessed by the Childhood Autism Rating Scale (CARS). Severity of gastrointestinal symptoms was assessed using a modified version of the 6-Item Gastrointestinal Severity Index (6-GSI) questionnaire. A control group of 40 healthy children matched for age and sex with the cases was also included to compare their levels of FC.
Results:
Gastrointestinal symptoms were present in 82.5% of children with autism; the most reported offensive stool odour (70%) and the least diarrhoea (17.5%), and a high 6-GSI score was observed in 35% of ASD children. FC levels were elevated in 35% of the cases and in 25% of the control group. The mean levels of FC of cases were significantly elevated compared to levels of controls. FC levels positively correlated with severity of gastrointestinal symptoms (6-GSI) in autistic patients. There was positive correlation between CARS and 6-GSI.
Conclusions:
Gastrointestinal manifestations are a common comorbidity in autistic patients. ASD patients have significantly higher FC levels than healthy controls. FC levels are strongly correlated with the severity of gastrointestinal manifestations in ASD children. So, gastrointestinal manifestations among autistic patients could be caused by gastrointestinal inflammation.
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