Cachexia: Difference between revisions

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	Cachexia;
ICD-10	R64
ICD-9	799.4

VisualWikitext

Latest revision as of 20:27, 10 January 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Cachexia (Template:PronEng) is loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite in someone who is not actively trying to lose weight. It can be a sign of various underlying disorders; when a patient presents with cachexia, a doctor will generally consider the possibility of cancer, certain infectious diseases (e.g. tuberculosis, AIDS) and some autoimmune disorders, or addiction to drugs such as amphetamines or cocaine. Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, asthenia, and anemia, and response to standard treatment is usually poor.

Disease settings

Cachexia is often seen in end-stage cancer, and in that context is called "cancer cachexia". It was also prevalent in AIDS patients before the advent of triple-therapy for that condition; now it is seen less frequently in those countries where such treatment is available. In those patients who have Congestive Heart Failure, there is also a cachectic syndrome. Also, a cachexia co-morbidity is seen in patients that have any of the range of illnesses classified as "COPD" (chronic obstructive pulmonary disease), particularly emphysema. Some severe cases of schizophrenia can present this condition where it is named vesanic cachexia.^[1]

In each of these settings there is full-body wasting, which hits the skeletal muscle especially hard, resulting in muscle atrophy.

Cachexia

Mechanism

The exact mechanism in which these diseases cause cachexia is poorly understood, but there is probably a role for inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) -which is also nicknamed cachexin for this reason-, Interferon gamma (IFNɣ), and Interleukin 6 (IL-6), as well as the tumor secreted proteolysis inducing factor (PIF).

Related malnutrition syndromes are kwashiorkor and marasmus, although these do not always have an underlying causative illness; they are most often symptomatic of severe malnutrition.

Those suffering from the eating disorder anorexia nervosa appear to have high plasma levels of ghrelin. Ghrelin levels are also high in patients who have cancer-induced cachexia (Garcia et al 2005).

Causes

Common Causes

Causes by Organ System

Cardiovascular	Cardiac cachexia, Congestive heart failure, Endocarditis, Polyarteritis nodosa
Chemical / poisoning	Mercury
Dermatologic	No underlying causes
Drug Side Effect	Amphetamine, Cidofovir, Pergolide, Pramipexole
Ear Nose Throat	No underlying causes
Endocrine	Addison's disease, Paraneoplastic syndrome
Environmental	No underlying causes
Gastroenterologic	Celiac disease, Chronic diarrhea, Crohn's disease
Genetic	Andrade's disease, Cystic fibrosis
Hematologic	No underlying causes
Iatrogenic	Chemotherapy, Radiotherapy
Infectious Disease	AIDS, Atypical pneumonia, Brucellosis, Hepatitis B, Leishmaniasis, Lung abscess, Mycobacterium tuberculosis, Sepsis, Trypanosomiasis, Tuberculosis, Visceral leishmaniasis
Musculoskeletal / Ortho	Riley-Shwachman syndrome
Neurologic	Familial amyloid polyneuropathy, Multiple sclerosis, Riley-Shwachman syndrome
Nutritional / Metabolic	Metabolic acidosis
Obstetric/Gynecologic	No underlying causes
Oncologic	Acute myelosclerosis, Breast cancer, Cancer cachexia, Chronic lymphocytic leukaemia, Colorectal cancer, Kaposi sarcoma, Leukemia, Liver cancer, Malignancy, Metastatic neoplasm, Myeloma, Pancreatic cancer, Paraneoplastic syndrome, Stomach cancer
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	Anorexia nervosa, Depression
Pulmonary	COPD, Atypical pneumonia, Lung abscess
Renal / Electrolyte	Chronic renal failure
Rheum / Immune / Allergy	Mastocytosis, Sarcoidosis, Systemic lupus erythematosus, Polyarteritis nodosa
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Starvation

Causes in Alphabetical Order

References

↑ "Vesanic" means demented.

Related Chapters

Wasting

Resources

[1] "Vesanic" means demented.

[1]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Infobox_Disease |
    Name        = Cachexia |
@@ Line 31: / Line 32: @@
 Those suffering from the eating disorder [[anorexia nervosa]] appear to have high plasma levels of [[ghrelin]]. [[Ghrelin]] levels are also high in patients who have cancer-induced '''cachexia''' (Garcia et al 2005).
+==Causes==
+===Common Causes===
+*[[AIDS]]
+*[[Cancer cachexia]]
+*[[Cardiac cachexia]]
+===Causes by Organ System===
+{|style="width:80%; height:100px" border="1"
+|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
+|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac cachexia]], [[Congestive heart failure]], [[Endocarditis]], [[Polyarteritis nodosa]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Chemical / poisoning'''
+|bgcolor="Beige"| [[Mercury ]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dermatologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Drug Side Effect'''
+|bgcolor="Beige"| [[Amphetamine]], [[Cidofovir]], [[Pergolide]], [[Pramipexole]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Ear Nose Throat'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Endocrine'''
+|bgcolor="Beige"| [[Addison's disease]], [[Paraneoplastic syndrome]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Environmental'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Gastroenterologic'''
+|bgcolor="Beige"| [[Celiac disease]], [[Chronic diarrhea]], [[Crohn's disease]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Genetic'''
+|bgcolor="Beige"| [[Andrade's disease]], [[Cystic fibrosis]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Hematologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Iatrogenic'''
+|bgcolor="Beige"| [[Chemotherapy]], [[Radiotherapy]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Infectious Disease'''
+|bgcolor="Beige"| [[AIDS]], [[Atypical pneumonia]], [[Brucellosis]], [[Hepatitis B]], [[Leishmaniasis]], [[Lung abscess]], [[Mycobacterium tuberculosis]], [[Sepsis]], [[Trypanosomiasis]], [[Tuberculosis]], [[Visceral leishmaniasis]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Musculoskeletal / Ortho'''
+|bgcolor="Beige"| [[Riley-Shwachman syndrome]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Neurologic'''
+|bgcolor="Beige"| [[Familial amyloid polyneuropathy]], [[Multiple sclerosis]], [[Riley-Shwachman syndrome]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Nutritional / Metabolic'''
+|bgcolor="Beige"| [[Metabolic acidosis]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Obstetric/Gynecologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Oncologic'''
+|bgcolor="Beige"| [[Acute myelosclerosis]], [[Breast cancer]], [[Cancer cachexia]], [[Chronic lymphocytic leukaemia]], [[Colorectal cancer]], [[Kaposi sarcoma]], [[Leukemia]], [[Liver cancer]], [[Malignancy]], [[Metastatic neoplasm]], [[Myeloma]], [[Pancreatic cancer]], [[Paraneoplastic syndrome]], [[Stomach cancer]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Opthalmologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Overdose / Toxicity'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Psychiatric'''
+|bgcolor="Beige"| [[Anorexia nervosa]], [[Depression]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Pulmonary'''
+|bgcolor="Beige"| [[COPD]], [[Atypical pneumonia]], [[Lung abscess]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Renal / Electrolyte'''
+|bgcolor="Beige"| [[Chronic renal failure]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Rheum / Immune / Allergy'''
+|bgcolor="Beige"| [[Mastocytosis]], [[Sarcoidosis]], [[Systemic lupus erythematosus]], [[Polyarteritis nodosa]]
+|-
+|-bgcolor="LightSteelBlue"
+| '''Sexual'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Trauma'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Urologic'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Dental'''
+|bgcolor="Beige"| No underlying causes
+|-
+|-bgcolor="LightSteelBlue"
+| '''Miscellaneous'''
+|bgcolor="Beige"| [[Starvation]]
+|-
+|}
+===Causes in Alphabetical Order===
+{{columns-list|
+*[[Acute myelosclerosis]]
+*[[Addison's disease]]
+*[[AIDS]]
+*[[Amphetamine]]
+*[[Andrade's disease]]
+*[[Anorexia nervosa]]
+*[[Atypical pneumonia]]
+*[[Breast cancer]]
+*[[Brucellosis]]
+*[[Cancer cachexia]]
+*[[Cardiac cachexia]]
+*[[Celiac disease]]
+*[[Chemotherapy]]
+*[[Chronic diarrhea]]
+*[[Chronic lymphocytic leukaemia]]
+*[[Chronic renal failure]]
+*[[Cidofovir]]
+*[[Colorectal cancer]]
+*[[Congestive heart failure]]
+*[[COPD]]
+*[[Crohn's disease]]
+*[[Cystic fibrosis]]
+*[[Depression]]
+*[[Endocarditis]]
+*[[Familial amyloid polyneuropathy]]
+*[[Hepatitis B]]
+*[[Kaposi sarcoma]]
+*[[Leishmaniasis]]
+*[[Leukemia]]
+*[[Liver cancer]]
+*[[Lung abscess]]
+*[[Malignancy]]
+*[[Mastocytosis]]
+*[[Mercury ]]
+*[[Metabolic acidosis]]
+*[[Metastatic neoplasm]]
+*[[Multiple sclerosis]]
+*[[Mycobacterium tuberculosis]]
+*[[Myeloma]]
+*[[Pancreatic cancer]]
+*[[Paraneoplastic syndrome]]
+*[[Pergolide]]
+*[[Polyarteritis nodosa]]
+*[[Radiotherapy]]
+*[[Sarcoidosis]]
+*[[Sepsis]]
+*[[Starvation]]
+*[[Stomach cancer]]
+*[[Systemic lupus erythematosus]]
+*[[Trypanosomiasis]]
+*[[Tuberculosis]]
+*[[Visceral leishmaniasis]]
+}}
 ==References==
 {{Reflist|2}}
-==Related chapters==
+==Related Chapters==
 * [[Wasting]]
@@ Line 46: / Line 224: @@
 *[http://www.medterms.com/script/main/art.asp?articlekey=11065 Medicine Net.com - Definition of Cachexia]
-{{Symptoms and signs}}
-[[Category:Medical signs]]
 [[Category:Physiology]]
 [[Category:Pathology]]
-[[Category:Symptoms]]
+[[Category:Medical signs]]
 [[Category:Signs and symptoms]]
-[[Category:Oncology]]
-[[de:Kachexie]]
-[[es:Caquexia]]
-[[fr:Cachexie]]
-[[nl:Cachexie]]
-[[ja:悪液質]]
-[[pl:Wyniszczenie]]
-[[pt:Caquexia]]
-[[qu:Amaychura]]
-[[sv:Kakeksi]]
-[[zh:惡病體質]]
-{{WH}}
-{{WS}}