Cachexia: Difference between revisions

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{|style="width:80%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac cachexia]], [[Congestive heart failure]], [[Endocarditis]], [[Polyarteritis nodosa]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Mercury ]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Amphetamine]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Addison's disease]]
|-  
|-  
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Celiac disease]], [[Chronic diarrhea]], [[Crohn's disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Andrade's disease]], [[Cystic fibrosis]]
|-
|-
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|-bgcolor="LightSteelBlue"
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| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Chemotherapy]], [[Radiotherapy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[AIDS]], [[Atypical pneumonia]], [[Brucellosis]], [[Hepatitis B]], [[Leishmaniasis]], [[Lung abscess]], [[Mycobacterium tuberculosis]], [[Sepsis]], [[Trypanosomiasis]], [[Tuberculosis]], [[Visceral leishmaniasis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Riley-Shwachman syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Familial amyloid polyneuropathy]], [[Multiple sclerosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Metabolic acidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|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]]
|-
|-
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|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Anorexia nervosa]], [[Depression]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[COPD]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Chronic renal failure]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Mastocytosis]], [[Sarcoidosis]], [[Systemic lupus erythematosus]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Starvation]]
|-
|-
|}
|}

Revision as of 15:03, 3 April 2013

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

Media

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

Ongoing Trials on Cachexia at Clinical Trials.gov

Trial results on Cachexia

Clinical Trials on Cachexia at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Cachexia

NICE Guidance on Cachexia

NHS PRODIGY Guidance

FDA on Cachexia

CDC on Cachexia

Books

Books on Cachexia

News

Cachexia in the news

Be alerted to news on Cachexia

News trends on Cachexia

Commentary

Blogs on Cachexia

Definitions

Definitions of Cachexia

Patient Resources / Community

Patient resources on Cachexia

Discussion groups on Cachexia

Patient Handouts on Cachexia

Directions to Hospitals Treating Cachexia

Risk calculators and risk factors for Cachexia

Healthcare Provider Resources

Symptoms of Cachexia

Causes & Risk Factors for Cachexia

Diagnostic studies for Cachexia

Treatment of Cachexia

Continuing Medical Education (CME)

CME Programs on Cachexia

International

Cachexia en Espanol

Cachexia en Francais

Business

Cachexia in the Marketplace

Patents on Cachexia

Experimental / Informatics

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.[1]

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

  • Cachexia

    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
Ear Nose Throat No underlying causes
Endocrine Addison's disease
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
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
Renal / Electrolyte Chronic renal failure
Rheum / Immune / Allergy Mastocytosis, Sarcoidosis, Systemic lupus erythematosus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Starvation

Causes in Alphabetical Order


References

  1. ↑ "Vesanic" means demented.

Related Chapters

Resources

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