Al-Beltagi Mohammed
Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama P.O. Box 26671, Bahrain, Bahrain.
World J Clin Pediatr. 2021 May 9;10(3):15-28. doi: 10.5409/wjcp.v10.i3.15.
Medical comorbidities are more common in children with autism spectrum disorders (ASD) than in the general population. Some genetic disorders are more common in children with ASD such as Fragile X syndrome, Down syndrome, Duchenne muscular dystrophy, neurofibromatosis type I, and tuberous sclerosis complex. Children with autism are also more prone to a variety of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headaches, and congenital abnormalities of the nervous system. Besides, sleep disorders are a significant problem in individuals with autism, occurring in about 80% of them. Gastrointestinal (GI) disorders are significantly more common in children with ASD; they occur in 46% to 84% of them. The most common GI problems observed in children with ASD are chronic constipation, chronic diarrhoea, gastroesophageal reflux and/or disease, nausea and/or vomiting, flatulence, chronic bloating, abdominal discomfort, ulcers, colitis, inflammatory bowel disease, food intolerance, and/or failure to thrive. Several categories of inborn-errors of metabolism have been observed in some patients with autism including mitochondrial disorders, disorders of creatine metabolism, selected amino acid disorders, disorders of folate or B12 metabolism, and selected lysosomal storage disorders. A significant proportion of children with ASD have evidence of persistent neuroinflammation, altered inflammatory responses, and immune abnormalities. Anti-brain antibodies may play an important pathoplastic mechanism in autism. Allergic disorders are significantly more common in individuals with ASD from all age groups. They influence the development and severity of symptoms. They could cause problematic behaviours in at least a significant subset of affected children. Therefore, it is important to consider the child with autism as a whole and not overlook possible symptoms as part of autism. The physician should rule out the presence of a medical condition before moving on to other interventions or therapies. Children who enjoy good health have a better chance of learning. This can apply to all children including those with autism.
与普通人群相比，患有自闭症谱系障碍（ASD）的儿童中合并其他医学疾病的情况更为常见。某些遗传疾病在患有ASD的儿童中更为常见，如脆性X综合征、唐氏综合征、杜氏肌营养不良症、I型神经纤维瘤病和结节性硬化症。患有自闭症的儿童也更容易出现各种神经系统疾病，包括癫痫、巨头症、脑积水、脑瘫、偏头痛/头痛以及神经系统先天性异常。此外，睡眠障碍是自闭症患者中的一个重要问题，约80%的患者存在该问题。胃肠道（GI）疾病在患有ASD的儿童中明显更为常见；发生率在46%至84%之间。在患有ASD的儿童中观察到的最常见的胃肠道问题有慢性便秘、慢性腹泻、胃食管反流和/或疾病、恶心和/或呕吐、肠胃胀气、慢性腹胀、腹部不适、溃疡、结肠炎、炎症性肠病、食物不耐受和/或发育不良。在一些自闭症患者中观察到了几类先天性代谢缺陷，包括线粒体疾病、肌酸代谢紊乱、特定氨基酸紊乱、叶酸或维生素B12代谢紊乱以及特定溶酶体贮积症。相当一部分患有ASD的儿童有持续性神经炎症、炎症反应改变和免疫异常的迹象。抗脑抗体可能在自闭症中发挥重要的病理塑形机制。在所有年龄组的自闭症患者中，过敏性疾病明显更为常见。它们会影响症状的发展和严重程度。它们可能至少在相当一部分受影响的儿童中导致问题行为。因此，将患有自闭症的儿童视为一个整体很重要，不要忽视可能作为自闭症一部分的症状。在进行其他干预或治疗之前，医生应排除存在医学疾病的情况。身体健康的儿童有更好的学习机会。这适用于所有儿童，包括自闭症儿童。
