الفهرس 
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Abstract
The pathogenesis of autism is still not fully understood and is still a subject for research.
Aggression and self-injurious behaviors are among the manifestations of behavioral problems encountered in autism and can be both dangerous and distressing for affected children and their families.
In addition, sexual behaviors were found to be prevalent among ASD patients.
A male predominance has been found in the diagnosis of autism, with male: female ratios of 4.5:1.
Also, androgen levels were found to be higher in autistic children than in healthy controls.
For the above reasons, studies have been made on leuprolide acetate with promising results as regards decreased disease severity and improving associated aggression.
This study was done in two stages in the period from 2014 till 2018. The first stage was a cross-sectional study including randomly selected 35 male patients from those attending the Child and Adolescent Psychiatry Clinic, Pediatrics Hospital, Ain Shams University. Those underwent history taking and examination, anthropometric and pubertal assessment by Tanner staging and testicular volume measurement. They also underwent evaluation by DSM-V to confirm the diagnosis of autism spectrum disorder, CARS and ATEC scores and aggression was rated using the MOAS. Also LHRH analogue test was done to assess the hypothalamic-pituitary-gonadal axis of our patients. In the second stage, a sample of 10 patients were selected with the higher hormonal levels and/or more severe behavioral problems and those received a single dose of leuprolide acetate (Lupron depot 11.25mg) IM and then they were followed up after 3 and 6 months.
Our results revealed that aggression was present in 48.6% of patients, which was subdivided into 34.3% with minimal aggression and 14.3% with mild aggression according to the MOAS, 40% of patients had inappropriate sexual behavior and 31.4% had both problems.
CARS showed that 68.6% of patients had mild to moderate autism while 31.4% had severe autism.
FSH SDS was elevated in 22.9% of patients while the rest were normal. Conversely LH SDS was low in 2.9% of patients and the rest were normal. Free testosterone was not elevated in any of the patients.
There was a highly significant relationship between aggression and inappropriate sexual behavior and also with CARS score, while aggression was significantly related to ATEC scores.
There was a positive correlation between ATEC scores and FSH and FSH SDS.
Follow up of the treated group:
There was a non-significant change in bone age SDS, height SDS, BMI SDS.
There was a non-significant change in aggression as assessed by MOAS.
On the other side, there was a highly significant change in inappropriate sexual behaviors and hence a significant change in the group who had both aggression and inappropriate sexual behaviors.
As for their hormonal profile, a highly significant change occurred in FSH SDS but changes in LH SDS and free testosterone were non-significant.