Fever plus mitochondrial disease could be risk factors for autistic regression.
Autistic spectrum disorders encompass etiologically heterogeneous persons, with many genetic causes. A subgroup of these individuals has mitochondrial disease. Because a variety of metabolic disorders, including mitochondrial disease show regression with fever, a retrospective chart review was performed and identified 28 patients who met diagnostic criteria for autistic spectrum disorders and mitochondrial disease. Autistic regression occurred in 60.7% (17 of 28), a statistically significant increase over the general autistic spectrum disorder population (P < .0001). Of the 17 individuals with autistic regression, 70.6% (12 of 17) regressed with fever and 29.4% (5 of 17) regressed without identifiable linkage to fever or vaccinations. None showed regression with vaccination unless a febrile response was present. Although the study is small, a subgroup of patients with mitochondrial disease may be at risk of autistic regression with fever. Although recommended vaccinations schedules are appropriate in mitochondrial disease, fever management appears important for decreasing regression risk.
Shoffner
John
J
Medical Neurogenetics, LLC, Atlanta, Georgia 30338, USA. jshoffner@medicalneurogenetics.com
Hyams
Lauren
L
Langley
Genevieve Niedziela
GN
Cossette
Stephanie
S
Mylacraine
Lauren
L
Dale
Jeffrey
J
Ollis
Lisa
L
Kuoch
Sara
S
Bennett
Kevin
K
Aliberti
Audra
A
Hyland
Keith
K
D000293:Adolescent; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D002675:Child, Preschool; D015897:Comorbidity; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008928:Mitochondria / Q000235:genetics / Q000378:metabolism; D028361:Mitochondrial Diseases / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D015995:Prevalence; D012008:Recurrence; D012043:Regression, Psychology; D012189:Retrospective Studies; D012307:Risk Factors; D013312:Stress, Physiological / Q000502:physiology; D055815:Young Adult