MDNews - Cleveland-Akron-Canton

+++++++++++++++++ + +++ +PEDIATRICS U +++ +++++++++++++++++ RECENT RESEARCH FINDINGS MAY LEAD TO QUICK BLOOD AND URINE SCREEN FOR AUTISM. STUDY FINDS DRAMATIC INCREASE IN HOSPITALIZATION OF U.S. CHILDREN WITH IBD. The Centers for Disease Control and Prevention estimate that The largest investigation to date has found a dramatic increase in the one in 88 children may be affected by some form of Autism number of hospitalizations for children with inflammatory bowel disease Spectrum Disorders (ASD). Because the disorders are very (IBD) during the past decade in the United States. The new study, complex and multi-faceted, much effort has been put forth published in the August 2013 print issue of the Journal of Investigative to find biochemical markers to assist with diagnosis. A recent Medicine, found a 65 percent increase in IBD hospital discharges from finding by Charis Eng, MD, PhD, may lead to the development 2000 to 2009. The number increased from 11,928 discharges in 2000 to of a quick, noninvasive screening test for ASDs. Dr. Eng is Chair 19,568 discharges in 2009. of Genomic Medicine Institute and holder of The Sondra J. and The major types of IBD are Crohn's disease (CD) and ulcerative colitis Stephen R. Hardis Endowed Chair in Cancer Genomic Medicine at (UC). When looking at these two types of IBD individually, the authors Cleveland Clinic. She is also an American Cancer Society Clinical found a 59 percent increase in CD discharges and a 71 percent increase Research Professor. UC discharges. As reported in the European Journal of Human Genetics, The study looked at more than 11 million hospitalization records of Dr. Eng's research group, working with key collaborator Tom patients 20 years old and younger using a federal children's inpatient Frazier II, PhD, Director of Cleveland Clinic's Center for Autism, database. For the decade, they identified more than 61,000 pediatric examined blood and urine samples from 69 individuals with discharges with an IBD diagnosis. ASDs identified through the center. The group performed several According to the study's principal investigator, Thomas J. Sferra, MD, physiological measurements as well as genetic screening of these Division Chief of Pediatric Gastroenterology and Nutrition at UH individuals. Interestingly, they found high levels of a specific Rainbow Babies & Children's Hospital and Associate Professor of amino acid — aspartic acid — in the urine, irrespective of other Pediatrics at Case Western Reserve University School of Medicine, this factors. In addition, elevated or reduced levels of other specific increasing trend was present in each age category and across all geo- amino acids were found in the research participants' plasma. graphic regions (Northeast, Midwest, South and West). These encouraging results offer hope of improving and expediting diagnosis of ASDs. "The reason for this large increase in hospitalizations of children with IBD is not clear," says Dr. Sferra. "We also found an increase in "Because ASDs are highly variable, especially from a genetic IBD-related complications and co-existing conditions which suggest an point of view, genetic screening as a diagnostic method may prove increase in the severity of this disease has contributed to a greater need impractical and labor-intensive. Our results are promising, however, for hospitalization. However, we will need to perform more research to because we looked further downstream to observe a final common determine whether patients were admitted to the hospital due to IBD pathway, or end result, that is shared among ASDs," says Dr. Eng. or for an unrelated medical condition. Also, while we're seeing more This work was funded, in part, by the National Institutes of Health and strategic investment funds from the Pediatrics Institute of the Cleveland Clinic. 24 | Cleveland/Akron/Canton MD NEWS I MDNEWS.COM I SEPTEMBER- OCTOBER 2013 kids being discharged with IBD, we cannot with certainty say that the incidence and prevalence of childhood IBD has increased in U.S." I

• Cover