Objectives: To evaluate clinical features and diagnostic studies in catatonia in young adults with autism spectrum disorders.
Methods: A record review of 78 patients who presented to the Sutter Transition for Autism and Neurodevelopmental Disorders (S.T.A.N.D.) Clinic, a transition clinic for young adults with neurodevelopmental disorders, over 18-months since inception.
Results: Five cases (age range 16-29) out of 78 of teens and adults (age range 16-60) with autism spectrum disorders presented with catatonia. Laboratory screening revealed an elevated anti-DNase Ab (avg. 544 [340-1360]; nl <85) in all five subjects with catatonia and an elevated ASOT (avg 437.8 [105-1210]; nl <200) in three of the five with catatonia. No clear recent streptococcal infections were identified in these five subjects. Three subjects demonstrated a positive clinical response to immunotherapy (the other two patients are still being assessed and are likely going to start immunotherapy soon).
Conclusions: We hypothesize that the streptococcal antibodies may point to a neuro-autoimmunologic etiology of catatonia in autism spectrum disorders. Similar neuro-immunologic mechanisms have been proposed in other neurological disorders associated with streptococcal antibodies (PANDAS, Sydenham’s chorea, and post-streptococcal dystonia). Further investigation is important as this could represent a biomarker for catatonic patients who may respond to immunological treatment strategies.
See more of: Medical Co-Morbid Conditions
See more of: Symptoms, Diagnosis & Phenotype