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| |  "Strep" Infection May Cause One Type Of Anorexia BALTIMORE, MD -- August 13, 1997 -- Some cases of anorexia nervosa in youngsters may come on suddenly after a case of "strep" throat or other infection, suggests a study in the August issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Antibiotics may be useful in the treatment and prevention of these infection-triggered cases of anorexia, writes child and adolescent psychiatrist Dr. Mae S. Sokol of the Menninger Clinic in Topeka, Kansas. Dr. Sokol reports on three adolescents with anorexia nervosa that suddenly started or worsened around the time of streptococcal or other infection. One teenage boy developed anorexia after a bad case of strep throat. His eating disorder decreased while he was taking antibiotics prescribed for a sinus infection. When the antibiotics were finished, the anorexia returned. The patient was put back on antibiotics, and he improved again. This patient was treated with long-term antibiotics to prevent infections and had no further episodes of anorexia. In the other two patients reported, both the infection and anorexia got better on their own. "This is another series of cases, first reported in this Journal, of psychiatric illness in children triggered by infection," stated the Editor of the Journal, Dr. John F. McDermott. "The first report, two years ago, described children with the sudden onset of obsessive compulsive disorder (persistent irrational thoughts and behaviors after a strep infection). This report, by a different group of child and adolescent psychiatrists, suggests a similar mechanism in certain cases of anorexia nervosa (a serious illness marked by refusal to eat, weight loss and obsessive fears of getting fat). The importance of these two studies taken together is three-fold. They suggest: 1. what we have suspected all along, that these two disorders with their overlapping symptoms, may have underlining connections, and in some cases a common identifiable cause -- strep infection; 2. that the cause may lie in the brain cells or neurons in a certain region of the brain, being destroyed by the very antibodies the body produces to fight this infection in suceptible youngsters and; 3. that treatment with antibodies and modern immuno-technology can prevent or even reverse these difficult-to-treat illnesses and change what has been a poor outcome to a good outcome. In other words, these prelimenary studies, from independent groups of investigators in child and adolescent psychiatry, may lead to some of the most important breakthroughs in our field to date." Patients found to have infection-triggered anorexia could be monitored closely for infections -- treating the infection early and giving preventative antibiotics as is done with rheumatic fever, might prevent the eating disorder from getting worse. The researchers also suggest performing a strep test (throat culture and blood tests) in children and teenagers with anorexia that has suddenly appeared or worsened.
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