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Risk factors Abstract This study investigated whether common comorbidities or biochemical factors, such as allergic disease, anemia, inflammation, and neurotransmitters, are singly or additively associated with an increased risk of attention deficit—hyperactivity disorder ADHD.
We recruited children diagnosed with ADHD and age-, sex-, height-, weight-, and class-matched controls from 31 elementary schools in Taipei, Taiwan. The International Study of Asthma and Allergies in Childhood questionnaire was used to measure allergic symptoms. Fasting venous blood was collected and analyzed for complete blood count, white blood cell differential count, immunoglobulin Ig E level, and serotonin 5-HT level. Download PDF Introduction Attention deficit—hyperactivity disorder ADHD , one of the most frequent neuropsychiatric disorders found in children, is characterized by a lack of impulse control, inattention, and hyperactivity 1.
ADHD is associated with various comorbidities, including allergic disease, immune dysregulation, neurotransmitter underproduction, anemia, and oxidative and endocrinological imbalances 5 , 6. Regarding the neurophysiological mechanisms, various allergic diseases, including allergic rhinitis, atopic dermatitis, and asthma, have already been associated with ADHD 7 , 8 , 9 , 10 , Immune responses resulting from these allergic diseases may affect the central nervous system CNS and predispose children with neurodevelopmental disorders, including ADHD Furthermore, identifying allergic diseases in children exhibiting ADHD symptoms provides an opportunity to control allergies.
A recent randomized small-scale, placebo-controlled trial showed that rhinitis control combined with Ritalin administration can effectively alleviate ADHD endpoints Allergies result from immune responses that often involve chronic inflammation Immunoglobulin Ig E is an antibody found only in mammals, and an elevated IgE level is usually related to atopic diseases IgE-mediated allergic and inflammatory pathways are targets for intervention in the pathological processes of allergic diseases Furthermore, eosinophils, one of the five major leukocyte types, are responsible for tissue damage and inflammation in allergic diseases.
However, little is known about whether the markers of allergy i. Atopic diseases, such as eczema, asthma, hay fever, and food allergies, are associated with anemia The most prevalent form of anemia is iron deficiency anemia. Low levels of serum ferritin, a biomarker of iron store, are correlated with risks of cognitive deficits and behavioral and psychiatric problems in pediatric populations A large-scale field study demonstrated that a lower ferritin level may be associated with parent-reported hyperactivity after controlling for confounding factors Furthermore, research, including a Taiwanese study, has indicated that iron deficiency or iron deficiency anemia may be a potential risk factor for neurodevelopmental disorders including ADHD 20 , Iron deficiency may also reduce the effectiveness of psychostimulant treatment in children with ADHD A routine complete blood count CBC can detect anemia, a late-stage marker of iron deficiency.