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Familial Clustering of Autoimmune Disorders and Evaluation of Medical Risk Factors in Autism
Anne M. Comi, MD
Johns Hopkins Hospital, Division of Pediatric Neurology, and Kennedy Krieger Institute, Baltimore, MD, acomimd{at}aol.com, University of Tennessee, Developmental and Genetic Center, Knoxville, TN
Andrew W. Zimmerman, MD
Johns Hopkins Hospital, Division of Pediatric Neurology, and Kennedy Krieger Institute, Baltimore, MD, University of Tennessee, Developmental and Genetic Center, Knoxville, TN
Virginia H. Frye, EdD
Johns Hopkins Hospital, Division of Pediatric Neurology, and Kennedy Krieger Institute, Baltimore, MD, University of Tennessee, Developmental and Genetic Center, Knoxville, TN
Paul A. Law, MD, MPH
Johns Hopkins Hospital, Division of Pediatric Neurology, and Kennedy Krieger Institute, Baltimore, MD, University of Tennessee, Developmental and Genetic Center, Knoxville, TN
Joseph N. Peeden, MD
Johns Hopkins Hospital, Division of Pediatric Neurology, and Kennedy Krieger Institute, Baltimore, MD, University of Tennessee, Developmental and Genetic Center, Knoxville, TN
Autism is an age-dependent neurologic disorder that is often associated with autoimmune disorders in the patients' relatives. To evaluate the frequency of autoimmune disorders, as well as various prenatal and postnatal events in autism, we surveyed the families of 61 autistic patients and 46 healthy controls using questionnaires. The mean number of autoimmune disorders was greater in families with autism; 46% had two or more members with autoimmune disorders. As the number of family members with autoimmune disorders increased from one to three, the risk of autism was greater, with an odds ratio that increased from 1.9 to 5.5, respectively. In mothers and first-degree relatives of autistic children, there were more autoimmune disorders (16% and 21%) as compared to controls (2% and 4%), with odds ratios of 8.8 and 6.0, respectively. The most common autoimmune disorders in both groups were type 1 diabetes, adult rheumatoid arthritis, hypothyroidism, and systemic lupus erythematosus. Forty-six percent of the autism group reported having relatives with rheumatoid diseases, as compared to 26% of the controls. Prenatal maternal urinary tract, upper respiratory, and vaginal infections; asphyxia; prematurity, and seizures were more common in the autistic group, although the differences were not significant. Thirty-nine percent of the controls, but only 11% of the autistic group, reported allergies. An increased number of autoimmune disorders suggests that in some families with autism, immune dysfunction could interact with various environmental factors to play a role in autism pathogenesis. (J Child Neurol 1999;14:388-394).
Journal of Child Neurology, Vol. 14, No. 6,
388-394 (1999)
DOI: 10.1177/088307389901400608
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