Celiac Disease Presenting as Autism

The Journal of Child Neurology published a special article online June 29, 2009 (published ahead of printing) entitled “Celiac Disease Presenting as Autism.” The article is a case study of a 5-year-old boy diagnosed with autism and celiac disease. The boy was described as “an increasingly picky eater and would reject food on the basis of taste, smell, or appearance.”  He had severe language problems, as well as gastrointestinal symptoms including bloating, belching, abdominal pain, nausea, vomiting, and diarrhea.  He had deficiencies in fat-soluble vitamins (vitamins A, D, and E) and fatty acids (omega 3, omega 6, saturated fat), as well as low coenzyme Q10 and folate. Upon being assessed and diagnosed with celiac, the boy was put on a gluten-free diet and nutritional supplementation based on deficiencies.  “Fruits and vegetables were juiced to make nutrients easier to absorb, and fat-soluble vitamins, omega 3 fatty acids (in the form of cod liver oil), omega 6 fatty aids, and folic acid were given as supplements.”  According to the published article, “The patient’s gastrointestinal symptoms rapidly resolved, and signs and symptoms suggestive of autism progressively abated.” “Within 1 month, the boy’s gastrointestinal symptoms were relieved and his behavior had changed dramatically.  The mother excitedly reported that for the first time, her 5-year-old boy became progressively more communicative and told her that he loved her.  Within 3 months, his functioning had improve so much that he no longer required an individualized leaning program and was able to enter a normal classroom with no aide.” The authors of the article postulate that nutrient deficiencies caused by malabsorption from celiac disease caused the symptoms of autism, as they stated, “This case is an example of a common malabsorption syndrome associated with central nervous system dysfunction and suggests that in some contexts, nutritional deficiency may be a determinant of developmental delay.  It is recommended that all children with neurodevelopmental problems be assessed for nutritional deficiency and malabsorption syndromes.” Genuis SJ, Bouchard TP. Celiac Disease Presenting as Autism. J Child Neurology Online First. Published on June 29, 2009 as doi:10.1177/0883073809336127