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GASTROINTESTINAL SYMPTOMS AND INTESTINAL DISACCHARIDASE ACTIVITIES IN CHILDREN WITH AUTISM: 49

Kushak, Rafail I; Winter, Harland S; Farber, Nathan S; Buie, Timothy M

Journal of Pediatric Gastroenterology & Nutrition: October 2005 - Volume 41 - Issue 4 - p 508
Abstracts: North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Annual Meeting October 20-22, 2005 Salt Lake City, Utah: POSTER SESSION I THURSDAY, OCTOBER 20, 2005 5:00PM - 7:00PM: Nutrition, Absorption and Malabsorption

Pediatric GI/Nutrition, Massachusetts General Hospital, Boston, MA

Autistic children frequently suffer from diarrhea, abdominal pain, food intolerance and other gastrointestinal problems (GIP) that may contribute to their behavioral symptoms.

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Aim:

To determine disaccharidase activities in autistic (AI) and non-autistic individuals (NAI) with different GIP.

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Methods:

Specific activities for lactase, sucrase, maltase, and palatinase were studied in duodenal biopsies from 308 AI and 206 NAI selected for endoscopy based on a suspicion of GIP. Disaccharidase activities were analyzed for all patients based upon clinical report or diagnosis of diarrhea, abdominal pain, food sensitivity, failure to thrive (FTT), constipation, GER, or a combination of symptoms. Within each diagnostic category, activities for AI and NAI were determined. Cut off values for lactase, sucrase, maltase, and palatinase deficiency were correspondingly 15, 25, 100, and 5 U/g protein. Disaccharidase activities in intestinal biopsies were determined by Dahlqvist method; protein level was measured by Bradford method.

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Results:

The frequency of GIP among AI and NAI was: diarrhea, 38 vs 18 %; abdominal pain, 36 vs 59 %; food sensitivity, 14 vs 11%; constipation, 4 vs. 0.5%; GER, 3 vs. 11%; FTT, 2 vs. 6%; diarrhea with abdominal pain, 6 vs 5%; diarrhea with food sensitivity, 6 vs 3%; and abdominal pain with food sensitivity, 4 vs 3%. AI with diarrhea (n = 206) demonstrated significantly lower maltase (P < 0.05) activity than NAI with diarrhea. Frequency of lactase deficiency in AI with FTT (n = 5) was significantly higher (80% vs 25%; P < 0.05) than in NAI with FTT and frequency of palatinase deficiency in AI with diarrhea was significantly higher than in NAI (28% vs 11%; P < 0.05) with the same GIP. AI and NAI with other GIP had similar frequency of disaccharidase deficiencies.

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Conclusion:

Clinical indications for endoscopy based on GIP differ in AI and NAI. The clinical relevance of maltase deficiency in behavioral issues of AI with diarrhea needs to be determined. For most AI with GIP, the frequency of disaccharidase deficiency does not appear to differ from NAI.

© 2005 Lippincott Williams & Wilkins, Inc.