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Finally, in the February 25th New York Times oped page, Nicholas Kristof writes a column about toxins and their likely connection to the autism pandemic we are witnessing.  He says "what we dont know CAN hurt us."  Truer words were never spoken, I say.

In his piece he discusses the obvious connection of brain development and intrauterine exposure to toxins.  Concern about toxcins in the environment used to be a fringe view.  But alarm has moved into the medical mainstream.  Toxicologists, endocrinologists and oncologists seem to be the most concerned.  AND ME of course, the pediatrician whose hands have been raised asking the same questions for the past 7 or 8 years.

"Breast cancer, prostate cancer, AUTISM are three examples of diseases that are increasing in the population that we have no known cause for."  Although Mr, Kristof focuses on phtalates primarily there are over 80,000 known chemicals in our environment about which we know little of their potential toxicity to the human body.

I am anxious to read the upcoming artical in Current Opinion in Pediatrics written by Dr. Philip Landrigan, professor of pediatrics at the Mount Sinai School of Medicine.  Dr. Landrigan is increasingly confident that autism and other ailments are, in part, the result of the impact of environmental chemicals on the brain as it is being formed.

I encourage all of you to read this paper and consult doctors who can deal with this problem as a possible cause of your childs problems.
 
 
In the forefront of medical coding news, the diagnosis of Asperger's syndrome is about to be dropped from the DSM IV listings and rolled up into the categoryof 'autism spectrum disorder."   Well, Asperger's is an autism spectrum disorder!  The feeling is the diagnosis is misleading and invalid.  Maybe all of these diagnoses, which essentially describe what the patient is like but not WHY they are that way, should be dropped.  What is PDD-NOS anyway??  Most of these terms are merely descriptions of behaviors without getting to the root of the problem.  This is where investigation into mitochondrial function, central nervous system and immune system functions need to be investigated.  

As the author says about her daughter, diagnosed at age 3 years, "we no longer need the diagnosis of Asperger's disorder to reduce stigma And my daughter does not need the term Asperger's to bolster her self-esteem. Just last week, she introduced herself to a new teacher in her high school health class. "My name is Isabel," she said, "and my strength is that I have autism."
 
 
As a pediatrician reading this study back in 1998 I was shocked that someone had found evidence of measles virus living in the intestinal cells of children on the autistic spectrum.  As a neophyte in the field of autism then, the article made me think a little about the vaccines that were preventing 3 of the so called "usual childhood diseases" that we all contracted.  So routine were these viruses that when I contracted one, my brother and all my friends were moved into my room so that they could catch it and be done with the process for life.

The purpose of vaccinating against these viruses was to prevent the 1 in 100,000 chances of measles encephalitis, mumps orchitis leading to sterility in male children and rubella or german measles which could be devastating to a pregnant mom and her fetus.  While these viruses were known to have these consequences, there were no studies to corroborate their safetey or the remote possibility of adverse sequellae we are trying to address.  In fact, the original measles virus vaccine dating back to the 1950's was insufficient to provide life long immunity thus leading the American Academy of Pediatrics to recommend and ultimately require a second vaccination before college entry and prior to entering kindergarten.

There was never any question as from whom Dr. Wakefield received his funding. Is funding from anti-vaccine lawyers and parents any different than funding from pharmaceutical companies who promote many drugs without adequate testing on children? Is it any different than drug companies pushing swine flu vaccine with many known potentially toxic adjuvants on pregnant mothers and 6 month olds without adequate testing?

In truth, I am not anti vaccine.  What I am against is the notion that we should believe everything we hear that is perpetrated by drug companies and the congress who is lobbied  by drug companies. In fact, thanks to Dr Wakefield's work and the work of others in the autism community, we have learned about the high incidence of  inflammatory bowel/irritable bowel syndromes affecting the large percentage of patients on the autism spectrum.  Regardless of the coincidental findings of bowel disease, measles viruses inhabiting the bowel, lymphonodular hyperplasia in the ileum or the fact that most of our patients dont even know what a normal bowel movement is, it is important to stay on task to determine which of our patients is susceptible to these issues and what the genetic and environmental triggers are at play in determining bowel problems.

Yes, Lancet retracted the study as being biased. However, there are many studies that seem to be biased in favor of continuing the path we are on; the one where autism is increasing exponentially and pediatricians like me are scratching our heads trying to solve this mystery.