Background: The pathogenesis of anorexia nervosa (AN) is controversial.
Method: A retrospective case series was studied to investigate the post-viral onset of AN.
Results: Four consecutive in-patients with severe restrictive AN spontaneously volunteered histories of 'glandular fever'-like illnesses immediately before the onset of their eating disorder. This association has not previously been described. Possible pathogenic pathways include both non-specific and specific viral disruptions in central homeostasis, particularly involving corticotrophin-releasing hormone (CRH) regulation.
Conclusion: Such mechanisms are speculative, but biologically and historically plausible.