Abstract
Autism is a developmental disorder characterized by pervasive social and communication impairments and restricted range of interests and activities. Although the specific cause is unknown, proposed etiologies for autism have included autoimmune dysregulation of cellular or humoral components and maternal–fetal immunoregulation problems. Juvenile rheumatoid arthritis (JRA) constitutes several heterogeneous arthritides with onset in childhood. JRA is believed to be an autoimmune disorder whose pathogenesis is currently being elucidated. We present a case report of a 6-year-old male diagnosed with both autism and systemic onset JRA (SO-JRA). This co-occurrence has not previously been reported in the medical literature and raises the issue of a possible association between these 2 entities. Additional research to determine the frequency with which these 2 disorders coexist and to delineate potential immune mechanisms in autism could provide insights as to the etiology of both autism and SO-JRA and/or suggest a pathway to address treatment.
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REFERENCES
Bailey, A., Phillips, W., and Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological perspectives. J. Child Psychol. Psychiatr. 37: 89–126.
Barton, M., and Volkmar, F. (1998). How commonly are known medical conditions associated with autism? J. Autism Dev. Disord. 28(4): 273–278.
Comi, A. M., Zimmerman, A. W., Frye, V. H., Law, P. A., and Peeden, J. N. (1999). Familial clustering of autoimmune disorders and evaluation of medical risk factors in autism. J. Child Neurol. 14(6): 388–394.
Deykin, E. Y., and MacMahon, B. (1979). Viral exposure and autism. Am. J. Epidemiol. 109: 628–638.
Filipek, P. A., Accardo, P. J., Baranek, G. T., Cook, E. H., Dawson, G., Gordon, B., Gravel, J. S., Johnson, C. P., Kallen, R. J., Levy, S. E., Minshew, N. J., Prizant, B. M., Rapin, I., Rogers, S. J., Stone, W. L., Teplin, S., Tuckman, R. F., and Volkmar, F. R. (1999). The screening and diagnosis of autistic spectrum disorders. J. Autism Dev. Disord. 29(6): 439–484.
Fishman, D., Faulds, G., Jeffery, R., Mohamed-Ali, V., Yudkin, J. S., Humphries, S., and Woo, P. (1998). The effect of novel polymorphisms in the interleukin-6 (IL-6) gene on IL-6 transcription and plasma IL-6 levels and an association with systemic juvenile chronic arthritis. J. Chem. Invest. 102: 1369–1376.
Gallagher, K. T., and Bernstein, B. (1999). Juvenile rheumatoid arthritis. Curr. Opin. Rheumatol. 11: 372–376.
Gupta, S., Aggarwal, S., and Heads, C. (1996). Brief report: Dysregulated immune system in children with autism: Beneficial effects of intravenous immune globulin on autistic characteristics. J. Autism Dev. Disord. 26(4): 439–452.
Gupta, S., Aggarwal, S., Rashanravan, B., and Lee, T. (1998). TH-1 and TH-2-like cytokines in CD4+ and CD8+ T cells in autism. J. Neuroimmunol. 85(1): 106–109.
Moore, T. L. (1999). Immunopathogenesis of juvenile rheumatoid arthritis. Curr. Opin. Rheumatol. 11: 377–388.
Onel, K. B. (2000). Advances in the medical treatment of juvenile rheumatoid arthritis. Curr. Opin. Pediatr. 12(1): 72–75.
Peltola, H., Patja, A., Leinikki, P., Valle, M., Davidkin, I., and Paunio, M. (1998). No evidence for measles, mumps and rubella vaccine associated in inflammatory bowel disease or autism in a 14 year prospective study. Lancet 351(9112): 1327–1328.
Plioplys, A. V. (1998). Intravenous immunogloglobulin treatment of children with autism. J. Child Neurol. 13(2): 79–82.
Shoenfeld, A., and Aron-Maor, A. (2000). Vaccination and autoimmunity—Vaccinosis: A dangerous liaison? J. Autoimmun. 14: 1–10.
Smalley, S. L., Asarnon, R. F., and Spencer, A. M. (1988). Autism and genetics. Arch. Genl. Psychiatry 45: 953–961.
Taylor, B., Miller, E., Farrington, C. P., Petropoulos, M. C., Fayvot-Mayaud, I., Li, J., and Waight, P. A. (1999). Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal assessment. Lancet 353: 2026–2029.
VanGent, J., Heijnen, C. J., and Treffers, P. D. A. (1997). Autism and the immune system. J. Child Psychol. Psychiatr. 38(3): 337–349.
Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., Berelowitz, M., Dhillon, A. P., Thomson, M. A., Harvey, P., Valentine, A., Davies, S. E., and Walker-Smith, J. A. (1998). Ileal lymphoid nodular hyperplasia, nonspecific colitis, and pervasive developmental disorder in children. Lancet 351(1): 637–641.
Warren, R. P., Singh, V. K., Cole, P., Odell, J. D., Pingree, C. B., Warren, W. L., DeWitt, C. N., and McCullough, M. (1992). Possible association of the extended MHC haplotype B44-SC30-DR4 with autism. Immunogenetics 36: 203–207.
Woo, P., and Wedderburn, L. R. (1998). Juvenile rheumatoid arthritis. Lancet 351(9107): 969–973.
Zimmerman, A. W. (2000). Commentary: Immunological treatments for autism: In search of reasons for promising approaches. J. Autism Dev. Disord. 30: 481–484.
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Williams, G., McChane, R.H. & Schikler, K. Case Report: 6-Year-Old Male with Autism and Systemic Onset Juvenile Rheumatoid Arthritis. Journal of Developmental and Physical Disabilities 16, 117–123 (2004). https://doi.org/10.1023/B:JODD.0000010043.89739.ca
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DOI: https://doi.org/10.1023/B:JODD.0000010043.89739.ca