Abstract
Pervasive Developmental Disorders (PDD) are chronic, lifelong disorders for which there is as yet no effective cure, and medical management remains a challenge for clinicians. The current report describes two patients affected by autistic disorder with associated gastrointestinal symptoms.They received multiple doses of intravenous secretin for a six-month period and were assessed with several specific outcome measures to evaluate drug effect.The administration of secretin led to some significant and lasting improvement in only one case.Gastroesophageal reflux may contribute to some of the behavioural problems and explain the effect of secretin since its suppressive effect on gastric secretion is well known. It is also true that autistic children with gastroesophageal reflux and a higher IQ could constitute a subtype which responds to secretin administration and that could be labelled as a "gastrointestinal subtype".
Highlights
Pervasive Developmental Disorders (PDD) are chronic, lifelong disorders for which there is as yet no effective cure, and medical management remains a challenge for clinicians
Severe abnormal relationships Severe abnormal verbal communication Inappropriate crying Rocking Repetitive movements Abnormal adaptation to change Rituals Sleep problems Severe abnormal relationships Severe abnormal verbal communication Routine Obsessive interests Repetitive movements Self-injurious behaviour Tantrums hormone in the gastrointestinal system, but have firmly supported its neuropeptide role [4], since secretin has been shown to be capable of crossing the blood-brain barrier [5] and of depolarizing nucleus tractus solitarius neurons [6], activating brain regions including areas abnormal in autism [7]
We observed an evident amelioration of eating behavior associated with a stable global behavioral improvement. This observation drew our attention to gastrointestinal symptoms and eating behavior, to dieting, in that the importance of social interaction and eating behavior has been pointed out by several studies [26]
Summary
Pervasive Developmental Disorders (PDD) are chronic, lifelong disorders for which there is as yet no effective cure, and medical management remains a challenge for clinicians. In spite of improvements in some associated "problematic behaviors" with specific drugs, effective medical treatment for the core language- and social cognition-related symptoms are not available because the biology is not clearly understood and proper drug treatment has not been possible [1]. Since the experience of Horvath et al [3] regarding secretin administration, with their report of "a dramatic improvement in the behavior of autistic children, manifested by improved eye contact, alertness, expansion of expressive language", and "relief of gastrointestinal symptoms", particular attention has been given to the potential role of this biological agent on autism. Preliminary reports [8] on secretin application initially generated enthusiasm, especially among parents of children with PDD [9], recent controlled studies seem to have dampened such enthusiasm (for a review, see [10]), there is still some space for discussion Severe abnormal relationships Severe abnormal verbal communication Inappropriate crying Rocking Repetitive movements Abnormal adaptation to change Rituals Sleep problems Severe abnormal relationships Severe abnormal verbal communication Routine Obsessive interests Repetitive movements Self-injurious behaviour Tantrums hormone in the gastrointestinal system, but have firmly supported its neuropeptide role [4], since secretin has been shown to be capable of crossing the blood-brain barrier [5] and of depolarizing nucleus tractus solitarius neurons [6], activating brain regions including areas abnormal in autism [7].
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