Autism and Celiac Disease: Failure to Validate the Hypothesis of a Possible Link

Autism is a heterogeneous condition and the possible pathogenic role of several different factors was postulated. Previous studies reported the existence of a linkage between autism and celiac disease (CD). The aim of this study was to determine the association between autism and CD by anti-gliadin (AGA), antiendomysial (AEA) and tissue transglutaminase (tTG) antibodies. Thirty four consecutive autistic children (18 boys and 16 girls) aging 9.2±4.1 years (range 4-16 years) and thirty four age- and sex- matched healthy anonymous blood donors (18 boys and 16 girls) aging 10.8±4.0 years (range 4-16 years) were included. None of the patients and controls had symptoms (or positive family history) suggestive of specific gastrointestinal diseases. AGA and AEA antibodies (IgG and IgA), and IgA-tTG were detected by ELISA. The individuals with positive serology were offered duodenal biopsies. IgG-AGA was found in 4 patients (11.8%) and 2 controls (5.9%), while IgA-AGA was found in none of the patients and controls. All patients presented normal values of IgG and IgA-AEA similar to the control group. There was no significant relationship between the levels of AGA and AEA antibodies and the severity of autism in the patient group. The levels of IgA-tTG in four patients (but no controls) were in the borderline range and two of them were found to have mild villous changes with chronic inflammatory cells. However, characteristic histological features of CD were absent. No evidence was found that children with autism were more likely to have celiac disease than children without autism.