Selective Hematological Profiles in Drug-Naïve Early Autism: Clinical and Developmental Correlates

Area of Science:

• Pediatric Neurology
• Immunology
• Developmental Pediatrics

Background:

• Peripheral biomarkers for autism spectrum disorder (ASD) have yielded inconsistent results in prior research.
• Investigating complete blood count (CBC)-derived immune-inflammatory markers, micronutrients, and thyroid function in newly diagnosed, drug-naïve preschoolers with ASD is crucial.
• Understanding the relationship between these biomarkers, symptom severity, and developmental outcomes is essential for early intervention.

Purpose of the Study:

• To compare CBC-derived immune-inflammatory markers, iron, micronutrient levels, and thyroid function between drug-naïve preschoolers with ASD and healthy controls.
• To examine the associations between these peripheral markers, ASD symptom severity, and developmental skills.
• To explore potential sex-specific patterns in these markers within the ASD cohort.

Main Methods:

• A retrospective case-control study involving 62 children with ASD (24-72 months) and 61 age-matched healthy controls.
• Assessment of symptom severity, behavioral traits, and developmental status using the Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), and Denver II Developmental Screening Test (DDST).
• Calculation of composite inflammatory indices from hemogram data, employing Holm-Bonferroni corrections and bootstrap confidence intervals for statistical analysis.

Main Results:

• Children with ASD exhibited significantly lower mean corpuscular volume (MCV) and mean platelet volume (MPV), alongside higher absolute lymphocyte counts (LYMPH).
• Initial differences in ferritin, serum iron, and transferrin saturation were not statistically significant after adjustments.
• Higher CARS and ABC scores correlated with poorer personal-social and language development scores on the DDST. Exploratory analyses suggested potential sex-specific patterns in lymphocytes for girls, requiring further investigation.

Conclusions:

• Newly diagnosed, drug-naïve preschoolers with ASD present a unique baseline blood profile characterized by lower MCV and MPV and elevated lymphocyte counts.
• Clinical challenges in ASD are most pronounced in the personal-social and language domains.
• Routine hemograms may have limited primary diagnostic value for ASD, but exploratory sex-stratified immune marker patterns warrant validation in larger cohorts.