Autistic Enterocolitis - Lancet Study

Lancet Study

When Wakefield and his colleagues first reported in 1998 a possible association between autistic regression, IBD, and MMR vaccines in the Lancet, they evaluated a dozen children with pervasive developmental disorders, apparent developmental regression, and intestinal symptoms, referred to the Royal Free Hospital.

According to parents, onset of behavioral symptoms was linked to recent (within two weeks) immunization with MMR vaccine in eight of the children diagnosed with developmental disorders. The most consistent report was lymphoid nodular hyperplasia of the terminal ileum in nine of the children. This feature has also been reported to be very common in non-autistic children. A variety of colonic and rectal mucosal features were reported in eight cases. Biopsies of the ileum were reported to have shown reactive lymphoid follicular hyperplasia in seven. Biopsies of the colon were reported to have shown a diffuse mononuclear cell infiltrate in six.

Wakefield and his colleagues said they described features of regressive autism with bowel disorders, or what Wakefield would later call autistic enterocolitis, although these findings have been questioned, with claims that the association of features is substantially an artifact of preselection of vaccinated children with both developmental disorders and bowel symptoms for a UK lawsuit:

• Most of the children were reported to have swelling of the lymphoid tissue lining the intestines, particularly near where the small and large intestines meet, and inflammation of the large intestine, associated with constipation, diarrhea and, in some cases, pain.
• In some affected children, impaired cellular immunity to common recall antigens, with low numbers of circulating white blood cells were reported.
• A specific measles protein signal is claimed to have been detected in inflamed lymphoid tissue.
• In some cases, loss of speech and language, bowel disturbances, self-injury, and a self-limited diet, associated with cravings for particular foods.
• Allergies, food intolerances are also reported in some children.

In an April 2010 investigation into the origins of claims for "autistic enterocolitis", reporter Brian Deer revealed in the BMJ that the original pathology results on the children in the study (obtained from the Royal Free hospital) had been subjected to wholesale changes, from normal to abnormal, in the medical school. On 2 January 2011, Deer provided two tables comparing the data on the twelve children, showing the original hospital data and the data with the wholesale changes as used in the 1998 Lancet article.

A 2011 article in the British Medical Journal described how the data in the study had been falsified by Wakefield so it would arrive at a predetermined conclusion. An accompanying editorial in the same journal described Wakefield's work as an "elaborate fraud" which led to lower vaccination rates, putting hundreds of thousands of children at risk and diverting energy and money away from research into the true cause of autism.