Familial Clustering of Autoimmune Disorders and Evaluation of Medical Risk Factors in Autism

TLDR

Autism is an age‑dependent neurologic disorder often associated with autoimmune disorders in relatives. The study surveyed families of 61 autistic patients and 46 healthy controls to evaluate the frequency of autoimmune disorders and various prenatal and postnatal events. Families were surveyed using questionnaires to assess autoimmune disorder prevalence and prenatal/postnatal events. Families of autistic children had a higher mean number of autoimmune disorders, with 46% having two or more, and autism risk rose with the number of affected relatives (odds ratios 1.9–5.5); mothers and first‑degree relatives showed higher rates (16% and 21% vs 2% and 4%) with odds ratios 8.8 and 6.0; type 1 diabetes, rheumatoid arthritis, hypothyroidism, and lupus were most common; 46% of autistic families reported rheumatoid diseases versus 26% of controls; prenatal infections, asphyxia, prematurity, and seizures were more common but not significant; 39% of controls but only 11% of autistic children reported allergies; these findings suggest immune dysfunction may interact with environmental factors in autism pathogenesis. J Child Neurol 1999;14:388‑394.

Abstract

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).