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], anti-endomysial [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 [lgG and IgA], and lgA-tTG were detected by ELISA. The individuals with positive serology were offered duodenal biopsies. lgG-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 lgG and lgA-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 lgA-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

Results and complications of endoscopic ultrasound guided-FNA in patients with pancreatic and gastrointestinal submucosal lesions

Linear endoscopic ultrasonography [EUS] is a proven modality for the diagnosis and treatment of different gastrointestinal lesions. The aim of this study was to describe the role of EUS-FNA in the evaluation of pancreatic and submucosal lesions. Over a 1-year period, in a prospective descriptive study, patients referred to Naft Hospital, underwent linear EUS. Of the 40 linear EUS performed, 32 [80%] patients had pancreatic lesions which 26 [81%] of these cases were referred for pancreatic tumor biopsy. The most of these tumors [73%] were in the head of pancreas. EUS-guided fine-needle aspiration biopsy was performed in all 26 patients successfully without complications, which in 16 [61.5%] of them the diagnosis of pancreatic malignancy confirmed cytopathologically. Sensitivity and specificity of this method in pancreatic lesions were 84% and 100%, respectively. Eight patients [20%] were referred because of submucosal upper gastrointestinal lesions which in 7 [87.5%] of them GIST were diagnosed. Sensitivity and specificity of EUSFNA in submucosal lesions was 100%. No adverse effect of EUS-FNA was observed. EUS-FNA is a safe method with an acceptable accuracy in the evaluation and diagnosis of pancreatic and submucosal lesions. The results of this study are similar to that reported previously from other countries. Performing this new method requires more gastroenterologists and pathologists experience as well as more support from different societies [such as gastroenterology and surgery]