Briefly Noted: Microscopic Duodenitis and Autism

A recent study (C Alessandria et al JPGN 2019; 69: 39-44) enrolled 151 patients to examine for correlation between mucosal disease and autistic children with gastrointestinal symptoms. Patients were prescribed a gluten-casein free diet (GCFD)

Key findings:

  • 134 (89%) had negative celiac disease serology
  • 56 (*37%) showed microscopic inflammation of duodenum
  • Response to GCFD diet was much higher in those with duodenitis (OR 11.3). It was unrelated to HLA-DQ2/DQ8 positivity (which was present in 48%)
  • Response to GCFD occureed with both rigourous and partial adherence without statistical difference

My view: The authors suggest that an EGD may help predict who would respond to GCFD. An alternative approach would be to offer a GCFD in those with significant GI symptoms given the unclear clinical relevance of microscopic duodenitis.  This view is supported by previous studies which have indicated that the GI findings are similar among children with and without autism.

Related blog posts:

Park Guell, Barccelona

 

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