Cachexia

Cachexia
ICD-10	R64
ICD-9	799.4

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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

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

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 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 Polyarteritis nodosa Radiotherapy Riley-Shwachman syndrome Sarcoidosis Sepsis Starvation Stomach cancer Systemic lupus erythematosus Trypanosomiasis Tuberculosis Visceral leishmaniasis

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