Journal of Pediatric Gastroenterology & Nutrition:
ABSTRACTS: Poster Session Abstracts
1Laboratoire de Biochimie, Hôpital Cochin Saint-Vincent de Paul, Paris, France, 2Service de Médecine Infantile C, Hôpital d’enfants, 3Service de Pédopsychiatrie, Hôpital Razi, 4Département de biochimie, Faculté de médecine de Tunis, Tunis, Tunisia
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Introduction: The intestinal permeability test (IPT) is regarded as a valuable and non-invasive test for monitoring small intestinal mucosal damage in children.
Gastrointestinal disorders such as chronic diarrhea, celiac disease, abdominal pain, discomfort have been reported in children with autism 1. D’Eufemia et al reported increased intestinal permeability in 9 of 21 autistic patients (43%)2.
Aim: The non-invasive intestinal permeability test (IPT) was selected to investigate the presence of gut mucosal damage in children with autism who had no clinical of known intestinal disorder.
Methods: We performed the IPT in a group of 15 autistic children (11 males and 4 females) aged 5½ up to 21 years (mean: 9.4 years). Informed consent was obtained from the parent(s) of each patient before the initiation of any procedures. Results are expressed as a percentage of urinary excretion of lactitol (L, %) and mannitol (M, %) (0.1 g/kg for each, oral absorption after a 6 h fast, 5 h urine collection, analysis by gas chromatography) and determination of the L/M ratio (L/M, %). The L/M cut-off value was set at 3.08 3.
Results: In eleven patients, the L/M recovery ratio was normal (1.81 +/− 0.84) with normal mannitol clearance (11.491 +/−3.603) and lactitol clearance (0.199 +/− 0.151). Four patients had an abnormally high L/M recovery ratio (11.12 +/− 13.83) with low mannitol clearance (9.33 +/− 3.35) and high lactitol clearance (0.691 +/− 0.466).
Conclusion: An abnormal IP was seen in 26.6% of our autistic children. Further investigations on the urinary peptides excretion are now in progress to confirm possible food (and/or environmental) poisoning in our autistic patients.
1. Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. (1999) Gastrointestinal abnormalities in children with autistic disorder. J Pediatr 135, 559–563.
2. D’Eufemia P et al. (1996) Abnormal intestinal permeability in children with autism. Acta Paediatr 85, 1076–1079.
3. Kalach N, Rocchiccioli F, de Boissieu D, Benahmou PH, Dupont C. (2001) Intestinal permeability in children: variation with age and reliability in the diagnosis of cow’s milk allergy. Acta Paediatr 90, 499–504.