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Archives of Disease in Childhood 2009;94:323-324; doi:10.1136/adc.2008.154443
Copyright © 2009 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

ARCHIMEDES

QUESTION 2

Veronica B Kelly, A Salt

Mary Sheridan Centre for Child Health, 5 Dugard Way off Renfrew Road, Kennington, London SE11 4TH, UK; vbkelly@gmail.com
Great Ormond Street Hospital NHS Trust/UCL Institute of Child Health, London, UK

The first 150 words of the full text of this article appear below.


SHOULD FRAGILE X BE TESTED FOR IN BOYS WITH A DIAGNOSIS OF AUTISTIC SPECTRUM DISORDER?

You diagnose a 5-year-old boy with autistic spectrum disorder. His examination is unremarkable and there is no family history of learning difficulties. Should you perform a molecular genetic screen for fragile X?


Clinical bottom line

  • Fragile X syndrome is significantly more common in children with autism (2%) than in the general male population (0.05%). (Grade C)
  • Approximately 50 children with autism would have to be tested to diagnose one child with fragile X syndrome. (Grade C)
  • Earlier identification of fragile X syndrome enables earlier genetic counselling and more accurate prognostic information to be offered. (Grade D)



STRUCTURED CLINICAL QUESTION

In boys with a diagnosis of autism [population] and no family history of learning disability [negative test result] what is the risk of fragile X syndrome [outcome]?


SEARCH STRATEGY AND OUTCOME

Searches were carried out using "Autism", "Autistic spectrum disorder" combined with "FRAX" and "fragile X".

Primary sources

PubMed: the search was limited to 1991–2008, as molecular genetic testing was routinely used to . . . [Full text of this article]


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