Cachexia

Cachexia
ICD-10	R64
ICD-9	799.4

WikiDoc Resources for Cachexia
Articles
Most recent articles on Cachexia Most cited articles on Cachexia Review articles on Cachexia Articles on Cachexia in N Eng J Med, Lancet, BMJ
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Powerpoint slides on Cachexia Images of Cachexia Photos of Cachexia Podcasts & MP3s on Cachexia Videos on Cachexia
Evidence Based Medicine
Cochrane Collaboration on Cachexia Bandolier on Cachexia TRIP on Cachexia
Clinical Trials
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US National Guidelines Clearinghouse on Cachexia NICE Guidance on Cachexia NHS PRODIGY Guidance FDA on Cachexia CDC on Cachexia
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List of terms related to Cachexia

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.

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

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  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

• AIDS
• Cancer cachexia
• Cardiac cachexia

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

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Related Chapters

• Wasting

Resources

• Manifestations of Cachexia, from Cancer Medicine
• Treatment of Cachexia, from Cancer Medicine
• Scientists find key to 'wasting syndrome' seen in cancer, AIDS (U.S. Department of Veterans Affairs)
• Vitamin E and Disease Treatment (Oregon State University)
• BioMedCode Animal Models for Cachexia / MOF (Tg211, TgE1355)
• Medicine Net.com - Definition of Cachexia