الفهرس 
Sensory problemOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Autism is a complex, behaviorally defined neuro-developmental disorder characterized by significant impairments in social interaction, verbal and non-verbal communication, and by restrictive, repetitive and stereotypic patterns of behavior. Autism spectrum disorders- include: 1. Autistic disorder. 2. Asperger‘s syndrome. 3. Pervasive developmental disorder-not otherwise specified (PDD- NOS), also called (atypical autism). 4. Rett‘s syndrome. 5. Childhood disintegrative disorder. Focused on Arab countries include two African countries (Egypt and Tunisia) in North Africa, the prevalence of ASDs among children with developmental disorders in Egypt and Tunisia was documented as 33.6% and 11.5% respectively. Autism is not a disease with a single etiology, but it is a heterogeneous behavioral syndrome associated with many etiologies. In 10-30% of cases, there is an identifiable etiology (secondary autism). In the majority of cases, there is no obvious cause (primary autism). Autism follows a steady course without remission, no cure is known. Children recover occasionally, so that they lose their diagnosis of ASD. Presentation can differ widely from one child to another, some are perceived by parents as ―different‖ during the first few months of life, others present with delayed speech development during the
second year of life and still other may appear to be normal only to regress and lose skills after the first year of life including 1) Impairment in social interaction, 2) Communication deficits, 3) Play skills lack of, or significantly delayed, 4) Stereotyped and repetitive behaviors. Children with ASDs appear to be at risk for Zn deficiency, Cu toxicity, have often low Zn/Cu ratio, and often disturbed metallothionein (MT) system functioning. Zinc, copper, various toxic heavy metals and oxidative stress up-regulate the gene expression of the metallothioneins. MTs are important proteins implicated in heavy metal, including Hg detoxification and in the elimination of free radicals throughout the body. MT induction by oxidative stress, excessive Cu levels, Hg or other toxic metals may lead to Zn deficiency by interfering with the intestinal absorption of this element and most likely also with its mobilization from the liver to other parts of the body. The aim of this study was to assess the plasma zinc/serum copper ratio as a biomarker in children with autism spectrum disorders. This study has been conducted on twenty children with autism and twenty healthy children served as a control group. All patients were subjected to thorough history taking, complete clinical examination, psychiatric evaluation (IQ assessment, DSM-IV-TR and CARS) and assessment of serum levels of copper and plasma zinc. The present study revealed the following results: 1- The mean plasma zinc was decreased in patients than controls
2- The mean serum copper was higher in patients than controls. 3- Low mean zinc/copper ratio in cases in comparison with controls. 4- IQ was lower in patients than controls 5- There was a significant positive correlation between age and zinc/copper ratio ,but there is no correlation between zinc /copper ratio with body mass index. 6- There was a negative correlation between CARS and zinc/copper ratio. 7- Zinc/copper ratio correlates with some selected symptom severity in autistic children. 8- According to ROC curve, The optimal cut-off value of serum levels of Zn/Cu was projected to be 0.81. A sensitivity of 85% and a specificity of 85%. The area under the curve was 0.93.