Cachexia: Difference between revisions
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[[File:Cancer-associated_cachexia_diagram.jpg|thumb | {{SI}} | ||
{{Infobox medical condition | |||
| name = Cachexia | |||
| image = [[File:Riehl_Zumbusch_Tafel_LVIII_(2).jpg]] | |||
| caption = Illustration of cachexia | |||
| field = [[Oncology]], [[Palliative care]] | |||
| synonyms = Wasting syndrome | |||
| symptoms = [[Weight loss]], [[muscle atrophy]], [[fatigue]], [[weakness]], [[loss of appetite]] | |||
| complications = [[Infection]], [[organ failure]] | |||
| onset = Gradual | |||
| duration = Long term | |||
| causes = [[Cancer]], [[chronic obstructive pulmonary disease]], [[chronic heart failure]], [[chronic kidney disease]], [[AIDS]] | |||
| risks = [[Chronic illness]], [[advanced age]] | |||
| diagnosis = [[Clinical assessment]], [[body mass index]] (BMI) < 20 kg/m², [[unintentional weight loss]] > 5% in 6 months | |||
| differential = [[Anorexia nervosa]], [[depression]], [[malabsorption]] | |||
| treatment = [[Nutritional support]], [[appetite stimulants]], [[anti-inflammatory drugs]], [[exercise]] | |||
| medication = [[Megestrol acetate]], [[corticosteroids]], [[anabolic steroids]] | |||
| prognosis = Poor, often associated with [[increased mortality]] | |||
| frequency = Common in advanced [[cancer]] and [[chronic illness]] | |||
}} | |||
[[File:Cancer-associated_cachexia_diagram.jpg|left|thumb]] '''Cachexia''' is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults or growth failure in children. Cachexia is distinct from starvation, age-related loss of muscle mass ([[sarcopenia]]), primary depression, malabsorption, and hyperthyroidism. | |||
== Etiology == | == Etiology == | ||
Cachexia is commonly associated with chronic diseases such as [[cancer]], [[chronic obstructive pulmonary disease]] (COPD), [[chronic kidney disease]], [[chronic heart failure]], and [[acquired immunodeficiency syndrome]] (AIDS). The pathophysiology of cachexia involves a complex interaction between pro-inflammatory cytokines, neuroendocrine hormones, and metabolic abnormalities. | Cachexia is commonly associated with chronic diseases such as [[cancer]], [[chronic obstructive pulmonary disease]] (COPD), [[chronic kidney disease]], [[chronic heart failure]], and [[acquired immunodeficiency syndrome]] (AIDS). The pathophysiology of cachexia involves a complex interaction between pro-inflammatory cytokines, neuroendocrine hormones, and metabolic abnormalities. | ||
== Pathophysiology == | == Pathophysiology == | ||
The pathophysiology of cachexia is multifactorial and involves: | The pathophysiology of cachexia is multifactorial and involves: | ||
* Increased levels of pro-inflammatory cytokines such as [[tumor necrosis factor-alpha]] (TNF- | * Increased levels of pro-inflammatory cytokines such as [[tumor necrosis factor-alpha]] (TNF-α), [[interleukin-6]] (IL-6), and [[interleukin-1]] (IL-1). | ||
* Altered metabolism of carbohydrates, proteins, and fats. | * Altered metabolism of carbohydrates, proteins, and fats. | ||
* Increased muscle protein degradation and decreased muscle protein synthesis. | * Increased muscle protein degradation and decreased muscle protein synthesis. | ||
* Anorexia and reduced food intake due to the effects of cytokines and other factors on the central nervous system. | * Anorexia and reduced food intake due to the effects of cytokines and other factors on the central nervous system. | ||
== Clinical Features == | == Clinical Features == | ||
The clinical features of cachexia include: | The clinical features of cachexia include: | ||
| Line 18: | Line 35: | ||
* Anorexia and reduced food intake. | * Anorexia and reduced food intake. | ||
* Edema in some cases. | * Edema in some cases. | ||
== Diagnosis == | == Diagnosis == | ||
The diagnosis of cachexia is primarily clinical and based on the presence of significant weight loss and muscle wasting in the context of an underlying chronic disease. Diagnostic criteria may include: | The diagnosis of cachexia is primarily clinical and based on the presence of significant weight loss and muscle wasting in the context of an underlying chronic disease. Diagnostic criteria may include: | ||
* Unintentional weight loss of more than 5% of body weight over 6-12 months. | * Unintentional weight loss of more than 5% of body weight over 6-12 months. | ||
* Body mass index (BMI) less than 20 kg/ | * Body mass index (BMI) less than 20 kg/m² in adults. | ||
* Reduced muscle strength and physical performance. | * Reduced muscle strength and physical performance. | ||
== Management == | == Management == | ||
The management of cachexia involves a multidisciplinary approach, including: | The management of cachexia involves a multidisciplinary approach, including: | ||
| Line 31: | Line 46: | ||
* Physical exercise to improve muscle mass and strength. | * Physical exercise to improve muscle mass and strength. | ||
* Treatment of the underlying disease to reduce the inflammatory response. | * Treatment of the underlying disease to reduce the inflammatory response. | ||
== Prognosis == | == Prognosis == | ||
Cachexia is associated with poor prognosis and increased mortality, particularly in patients with advanced cancer and chronic heart failure. Early recognition and intervention are crucial to improve outcomes and quality of life. | Cachexia is associated with poor prognosis and increased mortality, particularly in patients with advanced cancer and chronic heart failure. Early recognition and intervention are crucial to improve outcomes and quality of life. | ||
== See Also == | == See Also == | ||
* [[Sarcopenia]] | * [[Sarcopenia]] | ||
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* [[Inflammation]] | * [[Inflammation]] | ||
* [[Muscle atrophy]] | * [[Muscle atrophy]] | ||
== References == | == References == | ||
{{Reflist}} | {{Reflist}} | ||
== External Links == | == External Links == | ||
{{Commons category|Cachexia}} | {{Commons category|Cachexia}} | ||
[[Category:Medical conditions]] | [[Category:Medical conditions]] | ||
[[Category:Symptoms and signs: Nutrition and metabolism]] | [[Category:Symptoms and signs: Nutrition and metabolism]] | ||
| Line 55: | Line 65: | ||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[Category:Infectious diseases]] | [[Category:Infectious diseases]] | ||
{{medicine-stub}} | {{medicine-stub}} | ||
Latest revision as of 21:08, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Cachexia | |
|---|---|
.jpg)
| |
| Synonyms | Wasting syndrome |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Weight loss, muscle atrophy, fatigue, weakness, loss of appetite |
| Complications | Infection, organ failure |
| Onset | Gradual |
| Duration | Long term |
| Types | N/A |
| Causes | Cancer, chronic obstructive pulmonary disease, chronic heart failure, chronic kidney disease, AIDS |
| Risks | Chronic illness, advanced age |
| Diagnosis | Clinical assessment, body mass index (BMI) < 20 kg/m², unintentional weight loss > 5% in 6 months |
| Differential diagnosis | Anorexia nervosa, depression, malabsorption |
| Prevention | N/A |
| Treatment | Nutritional support, appetite stimulants, anti-inflammatory drugs, exercise |
| Medication | Megestrol acetate, corticosteroids, anabolic steroids |
| Prognosis | Poor, often associated with increased mortality |
| Frequency | Common in advanced cancer and chronic illness |
| Deaths | N/A |
Cachexia is a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass. The prominent clinical feature of cachexia is weight loss in adults or growth failure in children. Cachexia is distinct from starvation, age-related loss of muscle mass (sarcopenia), primary depression, malabsorption, and hyperthyroidism.
Etiology[edit]
Cachexia is commonly associated with chronic diseases such as cancer, chronic obstructive pulmonary disease (COPD), chronic kidney disease, chronic heart failure, and acquired immunodeficiency syndrome (AIDS). The pathophysiology of cachexia involves a complex interaction between pro-inflammatory cytokines, neuroendocrine hormones, and metabolic abnormalities.
Pathophysiology[edit]
The pathophysiology of cachexia is multifactorial and involves:
- Increased levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 (IL-1).
- Altered metabolism of carbohydrates, proteins, and fats.
- Increased muscle protein degradation and decreased muscle protein synthesis.
- Anorexia and reduced food intake due to the effects of cytokines and other factors on the central nervous system.
Clinical Features[edit]
The clinical features of cachexia include:
- Significant weight loss over a short period.
- Muscle wasting and loss of muscle strength.
- Fatigue and weakness.
- Anorexia and reduced food intake.
- Edema in some cases.
Diagnosis[edit]
The diagnosis of cachexia is primarily clinical and based on the presence of significant weight loss and muscle wasting in the context of an underlying chronic disease. Diagnostic criteria may include:
- Unintentional weight loss of more than 5% of body weight over 6-12 months.
- Body mass index (BMI) less than 20 kg/m² in adults.
- Reduced muscle strength and physical performance.
Management[edit]
The management of cachexia involves a multidisciplinary approach, including:
- Nutritional support to increase caloric and protein intake.
- Pharmacological interventions such as appetite stimulants, anti-inflammatory agents, and anabolic agents.
- Physical exercise to improve muscle mass and strength.
- Treatment of the underlying disease to reduce the inflammatory response.
Prognosis[edit]
Cachexia is associated with poor prognosis and increased mortality, particularly in patients with advanced cancer and chronic heart failure. Early recognition and intervention are crucial to improve outcomes and quality of life.
See Also[edit]
References[edit]
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External Links[edit]
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