Editorial
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. May 9, 2021; 10(3): 15-28
Published online May 9, 2021. doi: 10.5409/wjcp.v10.i3.15
Autism medical comorbidities
Mohammed Al-Beltagi
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama P.O. Box 26671, Bahrain, Bahrain
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 0000000, Al Gharbia, Egypt
Author contributions: Al-Biltagi M wrote and revised the whole manuscript.
Conflict-of-interest statement: The author declares that he has no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MD, PhD, Chairman, Professor, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, King Abdulaziz Avenue, Manama P.O. Box 26671, Bahrain. mbelrem@hotmail.com
Received: January 23, 2021
Peer-review started: January 23, 2021
First decision: February 12, 2021
Revised: February 12, 2021
Accepted: March 17, 2021
Article in press: March 17, 2021
Published online: May 9, 2021
Processing time: 95 Days and 14.5 Hours
Abstract

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.

Keywords: Autism; Children; Medical comorbidity; Epilepsy; Sleep disorders; Allergy; Gastrointestinal diseases

Core Tip: Medical comorbidities are common in children with autism. Some genetic disorders are more common in children with autism spectrum disorders. Medical comorbidities have a significant impact on the child’s behaviour and development. Early identification and treatment of these comorbidities will help to improve the child’s ability to learn and improve his or her circumstances and those of his or her family.