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  Cachexia

Cachexia is a reduction of weight, muscle atrophy, fatigue, weakness and anorexia (a sizable loss of appetite - not anorexia nervosa) in a person who is not trying to lose weight. It can be a sign of a variety of underlying disorders; when a patient presents with cachexia, a physician will usually consider the likelihood of cancer, certain infectious diseases (e.g. tuberculosis, AIDS) and several autoimmune disorders. Cachexia physically weakens patients to a position of immobility stemming from anorexia, asthenia, and anemia, and response to typical treatment is usually meager.

Cachexia Weight loss
Cachexia


Disease Settings

Cachexia is usually seen in end-stage cancer, and in that context is called "cancer cachexia". It was also common in AIDS patients before the arrival of triple-therapy for that condition; now it is noticed less often in those countries where this 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), primarily emphysema.

In each of these settings there is full-body dissipation, which strikes the skeletal muscle the most, leading to muscle atrophy.

Mechanism

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

Associated malnutrition syndromes are kwashiorkor and marasmus, though these do not always have an underlying contributing illness; they are most often indicative of severe malnutrition.

Those suffering from the eating disorder anorexia nervosa seem to have high plasma levels of ghrelin. Ghrelin levels are also elevated in patients who have cancer-induced cachexia.

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