David Baxter PhD
Late Founder
Can Strep Throat Lead to Anorexia?
By Susan Dimitman Kathryn Zerbe, M.D., New York Times
June 28, 2010
Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, previously responded to readers? questions about anorexia, bulimia, binge eating and related problems. Here, she responds to a reader who developed anorexia after a severe case of strep throat.
Q. A number of years ago, several studies indicated there might be a link between strep infections and the onset of anorexia nervosa. When I was young, my own anorexia began immediately after a severe strep infection, though I was already "ripe" for anorexia nervosa beforehand. Have any further studies been done? ~ Tinytim, France
A. Dr. Kathryn Zerbe responds:
You are referring to a small number of case reports that linked the development of anorexia to a condition called PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection.
Since these reports were published in the late 1990s, there have been studies that specifically link some cases of anorexia to acute strep infection.
There is also ongoing investigation of how tics and obsessive-compulsive disorder, or OCD, may worsen after a strep infection in some children up to the age of puberty. Because anorexia and obsessive-compulsive disorder often occur together, it is possible that antibodies produced by the strep bacteria could affect the brain and trigger or worsen both disorders.
At the present time, however, the National Institute of Mental Health only links the PANDAS syndrome with tics and OCD, attention-deficit hyperactivity disorder, separation anxiety, sleep problems and mood changes. Children who have have OCD and tics associated with PANDAS usually improve once the infection clears, only to get worse if they get another strep infection.
Children without PANDAS but who have tics and OCD tend to have the disorder for a long time, with good days and bad days, but they don?t necessarily get worse when they get a strep infection. The mechanism for PANDAS remains unknown.
For more information on PANDAS, see the earlier Consults post, Can Strep Throat Lead to Behavior Problems?
By Susan Dimitman Kathryn Zerbe, M.D., New York Times
June 28, 2010
Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, previously responded to readers? questions about anorexia, bulimia, binge eating and related problems. Here, she responds to a reader who developed anorexia after a severe case of strep throat.
Q. A number of years ago, several studies indicated there might be a link between strep infections and the onset of anorexia nervosa. When I was young, my own anorexia began immediately after a severe strep infection, though I was already "ripe" for anorexia nervosa beforehand. Have any further studies been done? ~ Tinytim, France
A. Dr. Kathryn Zerbe responds:
You are referring to a small number of case reports that linked the development of anorexia to a condition called PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection.
Since these reports were published in the late 1990s, there have been studies that specifically link some cases of anorexia to acute strep infection.
There is also ongoing investigation of how tics and obsessive-compulsive disorder, or OCD, may worsen after a strep infection in some children up to the age of puberty. Because anorexia and obsessive-compulsive disorder often occur together, it is possible that antibodies produced by the strep bacteria could affect the brain and trigger or worsen both disorders.
At the present time, however, the National Institute of Mental Health only links the PANDAS syndrome with tics and OCD, attention-deficit hyperactivity disorder, separation anxiety, sleep problems and mood changes. Children who have have OCD and tics associated with PANDAS usually improve once the infection clears, only to get worse if they get another strep infection.
Children without PANDAS but who have tics and OCD tend to have the disorder for a long time, with good days and bad days, but they don?t necessarily get worse when they get a strep infection. The mechanism for PANDAS remains unknown.
For more information on PANDAS, see the earlier Consults post, Can Strep Throat Lead to Behavior Problems?
