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The UCLA-University of Utah epidemiologic survey of autism: Recurrent infections

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Abstract

Two hundred and forty-one children with autism were ascertained and diagnosed (DSM-III criteria) in an epidemiologic survey of Utah. Pediatric and other pertinent medical records were abstracted for 233 patients and 66 of their siblings without autism for otitis media, upper respiratory, and other infections. A significantly greater number of children with autism had recurrent otitis media, upper respiratory and other infections than their nonautistic siblings. A greater number of children with autisru with recurrent infections had lower IQ scores, seizures, hearing deficits, delayed motor milestones, poorer speech, congenital anomalies, feeding problems, vomiting, diarrhea, and other types of infections than children with autism with mild or no infections. The only significant pre-, peri-, or postnatal risk factors between children with autism with recurrent, mild or no infection was an increase in the maternal-fetal incompatibility (ABO or Rh) in the recurrent infection group. Half the families with more than one child with autism had recurrent infections and 72% of those children with concurrent diseases which effect the CNS had recurrent infections. Methodological limitations are discussed.

Résumé

241 enfants avec autisme furent repérés et diagnostiques (critères DSM III) dans une étude épidémiologique de l'Utah. Les données pédiatriques et autres données médicales pertinentes furent relevées pour 233 patients et 66 des membres de la fratrie, sans autisme, pour des infections de l'oreille moyenne, de l'appareil respiratoire supérieur et d'autres infections. Un nombre significativement plus grand d'enfants autistes présentait plus d'otites moyennes récurrentes, d'infections de l'appareil respiratoire supérieur ainsi que d'autres infections que les membres de leur fratrie non autistes. Les enfants autistes, présentant des infections récurrentes, avaient des scores au Q.I. plus bas, plus de crises d'épilepsie, de déficits auditifs, de retards moteurs, une parole plus pauvre, plus d'anomalies congénitales, de problèmes de nourriture, vomissements, diarrhées et d'autres types d'infections que les enfants autistes avec des infections légères ou pas d'infection. Les seuls facteurs de risques significatifs péri ou post-nataux pour les enfants autistes, avec infections récurrentes légères ou non, étaient un accroissement de l'incompatibilités maternelle foetale (ABO ou Rh) dans le groupe avec une infection récurrente. La moitié des sujets dans les families avec plus d'un enfant avec autisme avait des infections récurrentes et 72% de ces enfants avec des maladies touchant le système nerveux central avaient des infections récurrentes. Les limites méthodologiques sont discutées.

Zusammenfassung

241 Kinder mit Autismus wurden im Rahmen einer epidemiologischen Untersuchung von Utah rekrutiert und diagnostiziert (DSM-III-Kriterien). Pädiatrische und andere relevante medizinische Befunde im Hinblick auf Otitis media, Infektionen der oberen Luftwege und andere Infektionen wurden 233 Patienten und 66 ihrer Geschwister ohne Autismus jeweils zusammengefaßt. Eine signifikant größere Anzahl von Kindern mit Autismus hatten rezidivierende Otitiden, Infektionen der oberen Luftwege und andere Infektionen im Vergleich zu ihren Geschwistern ohne Autismus. Eine größere Anzahl der autistischen Kinder mitrezidivierenden Infekten wiesen niedrigere IQ-Werte auf, Anfälle, Hörstörungen, motorische Retardierung, schlechtere Sprache, kongenitale Anomalien, Ernährungsprobleme, Erbrechen, Durchfälle und andere Arten von Infektionen als diejenigen autistischen Kinder mit nur leichten bzw. keinen Infektionen. Der einzige signifikante prä-, peri-oder post-natale Risikofaktor, durch den sich Kinder mit Autismusund rezidivierenden Infekten von solchen mit leichten oder keinen Infekten unterschieden, war eine erhöhte Rate an maternal-fetaler Inkompatibilität (ABO oder Rh) in der Gruppe mit rezidivierenden Infekten. Die Hälfte der Familien mit mehr als einem Kind mit Autismus hatten rezidivierende Infekte, und 72% der Kinder mit zusätzlichen Krankheiten mit Auswirkungen auf das ZNS hatten rezidivierende Infekte. Die methodischen Grenzen werden aufgezeigt.

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  1. Neuropsychiatric Institute, 760 Westwood Plaza, 90024, Los Angeles, CA, USA

    Edward R. Ritvo

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  1. Anne Mason-Brothers
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  2. Edward R. Ritvo
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  3. B. J. Freeman
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  4. Lynn B. Jorde
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  5. Carmen C. Pingree
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  6. William M. McMahon
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  7. William R. Jenson
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  8. P. Brent Petersen
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  9. Amy Mo
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Work was done at the the Division of Mental Retardation and Chlld Psychiatry, Department of Psychiatry, University of California at Los Angeles and the University of Utah Salt Lake City, Utah

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Mason-Brothers, A., Ritvo, E.R., Freeman, B.J. et al. The UCLA-University of Utah epidemiologic survey of autism: Recurrent infections. European Child & Adolescent Psychiatry 2, 79–90 (1993). https://doi.org/10.1007/BF02098863

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