Email updates

Keep up to date with the latest news and content from BMC Medicine and BioMed Central.

Journal App

google play app store
Open Access Commentary

Corticosteroid therapy in regressive autism: Preliminary findings from a retrospective study

Sailaja Golla1* and John A Sweeney2

Author Affiliations

1 Division of Pediatric Neurology, Neurodevelopmental Pediatrics, UT Southwestern and Children's Medical Center at Dallas, Dallas, USA

2 Center for Autism and Developmental Disabilities, UT Southwestern and Children’s Medical Center at Dallas, Dallas, USA

For all author emails, please log on.

BMC Medicine 2014, 12:79  doi:10.1186/1741-7015-12-79

Published: 15 May 2014

Abstract

Some children with autism spectrum disorders (ASD; 15% to 30% of patients) show a significant and persistent regression in speech and social function during early childhood. There are no established treatments for the regressive symptoms. However, there are some known causes of this type of regression, such as Rett syndrome and Landau-Kleffner syndrome (LKS). In LKS, steroids have been used as a treatment. Some evidence suggests an autoimmune contribution to the pathophysiology of autism (Chez MG, Guido-Estrada N: Immune therapy in autism: historical experience and future directions with immunomodulatory therapy. Neurotherapeutics 2010, 7:293–301, Wasilewska J, Kaczmarski M, Stasiak-Barmuta A, Tobolczyk J, Kowalewska E: Low serum IgA and increased expression of CD23 on B lymphocytes in peripheral blood in children with regressive autism aged 3-6 years old. Arch Med Sci 2012, 8:324–331, Stefanatos G: Changing perspectives on Landau-Kleffner syndrome. Clin Neuropsychol 2011, 25:963–988), raising the possibility that steroids might be a useful therapy for regression in ASD. A retrospective study published in BMC Neurology by Duffy et al. (Duffy, et al: Corticosteroid therapy in regressive autism: A retrospective study of effects on the Frequency Modulated Auditory Evoked Response (FMAER), language, and behavior. BMC Neurol 2014, 14:70) reviewed 20 steroid treated R-ASD (STAR) patients and 24 ASD control patients not treated with steroids (NSA). Improvements in clinical function and in a neurophysiological biomarker were seen in the steroid-treated children pre- to post-prednisolone treatment. This research provides a rationale for a randomized trial with steroid therapy to determine the longer term benefits and complications of steroids in this population.

Please see related article http://www.biomedcentral.com/1471-2377/14/70/abstract webcite.

Keywords:
Autism; Regression; Corticosteroids; FMAER; Language; Behavior