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Infection-triggered anorexia nervosa in children: clinical description of four cases

M S Sokol1

  • 1Eating Disorders Program, The Menninger Clinic, Topeka, Kansas 66601, USA. sokolms@menninger.edu

Journal of Child and Adolescent Psychopharmacology
|August 10, 2000
PubMed

Insights

This study suggests a link between streptococcal infections and some pediatric anorexia nervosa cases. Antibiotic treatment, alongside conventional care, showed promise in improving symptoms and weight gain in affected children.

Area of Science:

  • Pediatric autoimmune neuropsychiatric disorders
  • Infectious disease and neuropsychiatric conditions

Background:

  • Anorexia nervosa (AN) is a severe eating disorder with limited treatment options.
  • A hypothesis suggests some pediatric AN cases may stem from pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS).

Observation:

  • Four adolescents (11-15 years) with PANDAS AN received antibiotics plus conventional treatment.
  • Evidence of streptococcal infection was assessed via clinical evaluation, cultures, and serological tests (anti-DNase B, ASO titers).
  • The D8/17 B-cell marker, linked to post-streptococcal autoimmunity, was also measured.

Findings:

  • All four patients showed signs of prior streptococcal infection and had the D8/17 marker (33% mean positive B cells).
  • Two patients had comorbid obsessive-compulsive disorder (OCD).
  • Treatment with antibiotics and conventional care led to weight restoration and reduced eating disorder and OCD symptoms.

Implications:

  • Findings suggest a potential link between infectious diseases and certain anorexia nervosa cases.
  • This opens avenues for novel therapeutic strategies targeting infections in AN treatment.
Abstract

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