The Dilemma of Raised Blood Levels of Folate and B12 in Autism

Abstract

It has recently been reported that a raised level of folate and/or vitamin B12 in the blood of a newly parturient woman forecasts a marked increase in the possibility that the newborn infant will later develop autisma. The text that follows refers to the cases of two boys, each of which had suffered repeated episodes of acute febrile cervical lymphadenopathy. The medical history of one of the boys revealed that he had been previously admitted to a hospital during an episode of febrile lymphadenopathy. An enlarged cervical node had been removed for biopsy and it had been reported that its architecture, apart from its enlargement, was normal. In addition, it had been found that blood levels of folate and vitamin B12 were markedly increased. His mother had been accused of giving him too many supplements of vitamins, including folate and vitamin B12. She stated that she had not been giving the boy any vitamin supplements at all, a fact that was met with disbelief. Both boys had been indulged with sweets and each were found to have laboratory evidence of thiamin deficiency or abnormal status. One of the boys was studied in detail and the elevation of folate and B12 in the blood was confirmed. He was treated with large doses of thiamin as an outpatient. On his return the blood folate and vitamin B12 were found to be in the normal range. Thiamin therapy was discontinued and three weeks later he had another episode of febrile lymphadenopathy which was preceded by nocturnal sleepwalking accompanied by spontaneous enuresis. Blood folate and B12 were again elevated and thiamin treatment was restarted. With overall improvement in health and no further episodes of febrile lymphadenopathy, the folate and B12 levels were again normal when he returned for follow-up.