I've done a lot of research in the last 24 hours. I've found a lot of interesting things about the strep/anorexia connection.
The scientific term is PANDAS-AN or Anorexia caused by "Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococci." There have been some small studies and ongoing research done through the National Institute of Health as well as other universities and research centers.
I'm probably oversimplifying this, but here is the basic idea. Strep triggers an immune response in every person's body. Because the strep is remarkably similar to our own cell structures, our immune system sometimes ends up attacking our own bodies (as in Rheumatic Fever our own immune system actually attacks and damages the heart). Anyway, the theory is that strep, in a similar way, is causing an autoimmune response either to areas of the brain associated with anorexia or areas near to those centers. In some cases, a blood test to determine antibody levels, followed with a course of antibiotics has resulted in anorexic symptoms abating. There has also been some discussion about these same areas becoming inflamed -- not necessarily damaged (which could explain why antibiotics could possibly "cure" the disease). Eventual damage to these centers could explain why patients that are more entrenched into the anorexia don't respond to the antibiotics.
My pediatrician just returned my call from yesterday. He recently went to a conference where PANDAS were discussed. We talked about the possible applications for N. He is going to contact some of the researchers/presenters and find out about suggested courses of action. Our pediatrician is a good man and a good doctor, even if he hasn't always been aware of needed care for my son. I'm pleased that he was willing to hear me out -- and I'm even more pleased that he was already aware of PANDAS.
I don't know if this is a solution or help for N. But he has such a history of strep. It seems logical that we should follow up with any possibilities in this line of research.