Titre du document / Document title

Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children

Auteur(s) / Author(s)

WAKEFIELD A. J. ⁽¹⁾ ; MURCH S. H. ⁽²⁾ ; ANTHONY A. ⁽¹⁾ ; LINNELL J. ⁽¹⁾ ; CASSON D. M. ⁽²⁾ ; MALIK M. ⁽²⁾ ; BERELOWITZ M. ⁽³⁾ ; DHILLON A. P. ⁽¹⁾ ; THOMSON M. A. ⁽²⁾ ; HARVEY P. ⁽⁴⁾ ; VALENTINE A. ⁽⁵⁾ ; DAVIES S. E. ⁽¹⁾ ; WALKER-SMITH J. A. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Inflammatory Bowel Disease Study Group, University Departments of Medicine and Histopathology, Royal Free Hospital and School of Medicine, London NW3 2QG, ROYAUME-UNI
⁽²⁾ University Department of Paediatric Gastroenterology, Royal Free Hospital and School of Medicine, London NW3 2QG, ROYAUME-UNI
⁽³⁾ University Department of Child and Adolescent Psychiatry, Royal Free Hospital and School of Medicine, London NW3 2QG, ROYAUME-UNI
⁽⁴⁾ University Department of Neurology, Royal Free Hospital and School of Medicine, London NW3 2QG, ROYAUME-UNI
⁽⁵⁾ University Department of Radiology, Royal Free Hospital and School of Medicine, London NW3 2QG, ROYAUME-UNI

Résumé / Abstract

Background We investigated a consecutive series of children with chronic enterocolitis and regressive developmental disorder. Methods 12 children (mean age 6 years [range 3-10], 11 boys) were referred to a paediatric gastroenterology unit with a history of normal development followed by loss of acquired skills, including language, together with diarrhoea and abdominal pain. Children underwent gastroenterological, neurological, and developmental assessment and review of developmental records. Ileocolonoscopy and biopsy sampling, magnetic-resonance imaging (MRI), electroencephalography (EEG), and lumbar puncture were done under sedation. Barium follow-through radiography was done where possible. Biochemical, haematological, and immunological profiles were examined. Findings Onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children, with measles infection in one child, and otitis media in another. All 12 children had intestinal abnormalities, ranging from lymphoid nodular hyperplasia to aphthoid ulceration. Histology showed patchy chronic inflammation in the colon in 11 children and reactive ileal lymphoid hyperplasia in seven, but no granulomas. Behavioural disorders included autism (nine), disintegrative psychosis (one), and possible postviral or vaccinal encephalitis (two). There were no focal neurological abnormalities and MRI and EEG tests were normal. Abnormal laboratory results were significantly raised urinary methylmalonic acid compared with age-matched controls (p=0.003), low haemoglobin in four children, and a low serum IgA in four children. interpretation We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.

Revue / Journal Title

Lancet   ISSN 0140-6736   CODEN LANCAO 

Source / Source

1998, vol. 351, n^o9103, pp. 637-641 (26 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lancet, London, ROYAUME-UNI  (1823) (Revue)

Mots-clés anglais / English Keywords

Enterocolitis ; Lymphoid hyperplasia ; Nodule ; Ileum ; Clinical investigation ; Clinical biology ; Behavioral disorder ; Triggering ; Viral disease ; Vaccination ; Case study ; Child ; Infection ; Human ; Digestive diseases ; Intestinal disease ; Disease of the small intestine ; Psychopathology ;

Mots-clés français / French Keywords

Entérocolite ; Hyperplasie lymphoïde ; Nodule ; Iléon ; Exploration clinique ; Biologie clinique ; Trouble comportement ; Déclenchement ; Virose ; Vaccination ; Etude cas ; Enfant ; Infection ; Homme ; Appareil digestif pathologie ; Intestin pathologie ; Intestin grêle pathologie ; Psychopathologie ;

Mots-clés espagnols / Spanish Keywords

Enterocolitis ; Hiperplasia linfoidea ; Nódulo ; Ileon ; Exploración clínica ; Biología clínica ; Trastorno conducta ; Inducción ; Virosis ; Vacunación ; Estudio caso ; Niño ; Infección ; Hombre ; Aparato digestivo patología ; Intestino patología ; Intestino delgado patología ; Psicopatología ;

Localisation / Location

INIST-CNRS, Cote INIST : 5004, 35400007871495.0100