Otizm Spektrum Bozukluğunda Regresyon ile İlişkili Klinik ve Otoimmün Değişkenler
Özet
In this cross-sectional case-control study it is aimed to investigatethe differences between ASD(Autism Spectrum Disorders) cases with regression and without regression in terms of autoimmune markers and clinical manifestations and assess the regression specific features. The study group is consisted of 24 patients with autistic regression aged between 2-6 years. The control group is consisted of 26nonregressive ASD patients with similar ages. All participants were assessed according to DSM 5 criteria, CARS (Childhood Autism Rating Scale) and ADST (Ankara Developmental Screening Test) were administered. All parents were asked to complete Aberrant Behavior Checklist (AuBC) and Autism Behavior Checklist (ABC) for their children. Also autoimmune encephalitis panel including neuronal surface autoantibodies (Anti-NMDA, Anti-CASPR2, Anti-LG1, Anti-Glutamat type AMPA 1-2, Anti GABA B, Anti-DPPX) and Anti-GAD antibody were assayed in serum samples. Results of the study indicated that there was no significant difference in CARS, ADST, AuBC, ABC scores between study and control groups. It was observed that early developmental milestones (i.e language skills, potty training, walking) were attained earlier in regressive group. There was no seropositivity of neuronal surface autoantibodies in any participant. However Anti-GAD antibodies were detected in the serum of 5 (20.8%) patients of children with autistic regression and of none of the controls. A significant direct relationship was found between the levels of language skills before the regression and regained after the regression. Gradual onset pattern of regression was shown to be associated with disruption in most of the behavioral domains especially social and self-help skills. According to our results, it is suggested that autoimmunity might have a specific contribution to the etiology of ASD. Also some novel findings related to the phenomenology of regression have been provided.
